Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy : Nationwide, population-based study
(2021) In PLoS ONE 16(6 June 2021).- Abstract
Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group... (More)
Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11-11.91), hospital (OR 2.16, 95% CI 1.53- 3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07-3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34-3.57), hospital (OR 2.02, 95% CI 1.66-2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54-2.35), hospital (OR 1.28, 95% CI 1.07-1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement.
(Less)
- author
- Godtman, Rebecka Arnsrud ; Persson, Erik ; Cazzaniga, Walter ; Sandin, Fredrik ; Carlsson, Stefan ; Ahlgren, Göran LU ; Johansson, Eva ; Robinsson, David ; Hugosson, Jonas and Stattin, Pär
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- in
- PLoS ONE
- volume
- 16
- issue
- 6 June 2021
- article number
- e0253081
- publisher
- Public Library of Science (PLoS)
- external identifiers
-
- pmid:34138904
- scopus:85108254865
- ISSN
- 1932-6203
- DOI
- 10.1371/journal.pone.0253081
- language
- English
- LU publication?
- yes
- id
- d827ab9b-08a0-450b-b998-02731c8cd0c5
- date added to LUP
- 2021-07-16 10:55:38
- date last changed
- 2024-06-15 13:34:13
@article{d827ab9b-08a0-450b-b998-02731c8cd0c5,
abstract = {{<p>Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11-11.91), hospital (OR 2.16, 95% CI 1.53- 3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07-3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34-3.57), hospital (OR 2.02, 95% CI 1.66-2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54-2.35), hospital (OR 1.28, 95% CI 1.07-1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement.</p>}},
author = {{Godtman, Rebecka Arnsrud and Persson, Erik and Cazzaniga, Walter and Sandin, Fredrik and Carlsson, Stefan and Ahlgren, Göran and Johansson, Eva and Robinsson, David and Hugosson, Jonas and Stattin, Pär}},
issn = {{1932-6203}},
language = {{eng}},
number = {{6 June 2021}},
publisher = {{Public Library of Science (PLoS)}},
series = {{PLoS ONE}},
title = {{Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy : Nationwide, population-based study}},
url = {{http://dx.doi.org/10.1371/journal.pone.0253081}},
doi = {{10.1371/journal.pone.0253081}},
volume = {{16}},
year = {{2021}},
}