The impact of hospital volume, residency, and fellowship training on perioperative outcomes after radical prostatectomy

Trinh, Quoc Dien; Sun, Maxine; Kim, Simon P.; Sammon, Jesse D.; Kowalczyk, Keith; Friedman, Ariella; Sukumar, Shyam; Ravi, Praful; Muhletaler, Fred; Agarwal, Piyush K.; Shariat, Shahrokh F.; Hu, Jim C.; Menon, Mani; Karakiewicz, Pierre I.

doi:10.1016/j.urolonc.2012.10.008

Cited by 37 publications

(24 citation statements)

References 23 publications

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“…In addition, most observational studies generally include men treated at high-volume tertiary referral centers. Since surgeon, radiotherapist, and oncology expertise, as well as hospital case volumes, affect treatment-related outcomes [18][19][20][21], results obtained in this setting might not be applicable to the general population. Unlike the majority of cancer data sets from large, highly specialized, singlecenter academic or tertiary referral institutions in the USA and Europe, registries reflect outcomes in men with PCa treated in real-world community settings.…”

Section: A Role For Pca Registriesmentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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Context: Disease-specific registries that enroll a considerable number of patients play a major role in prostate cancer (PCa) research. Objective: To evaluate available registries, describe their strengths and limitations, and discuss the potential future role of PCa registries in outcomes research. Evidence acquisition: We performed a literature review of the Medline, Embase, and Web of Science databases. The search strategy included the terms prostate cancer, outcomes, statistical approaches, population-based cohorts, registries of outcomes, and epidemiological studies, alone or in combination. We limited our search to studies published between January 2005 and January 2015. Evidence synthesis: Several population-based and prospective disease-specific registries are currently available for prostate cancer. Studies performed using these data sources provide important information on incidence and mortality, disease characteristics at presentation, risk factors, trends in utilization of health care services, disparities in access to treatment, quality of care, long-term oncologic and health-related quality of life outcomes, and costs associated with management of the disease. Although data from these registries have some limitations, statistical methods are available that can address certain biases and increase the internal and external validity of such analyses. In the future, improvements in data quality, collection of tissue samples, and the availability of data feedback to health care providers will increase the relevance of studies built on population-based and disease-specific registries. Conclusions: The strengths and limitations of PCa registries should be carefully considered when planning studies using these databases. Although randomized controlled trials still provide the highest level of evidence, large registries play an important and growing role in advancing PCa research and care. Patient summary: Several population-based and prospective disease-specific registries for prostate cancer are currently available. Analyses of data from these registries yield information that is clinically relevant for the management of patients with prostate cancer.

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Section: A Role For Pca Registriesmentioning

confidence: 99%

Prostate Cancer Registries: Current Status and Future Directions

Gandaglia¹,

Bray

Cooperberg

et al. 2016

European Urology

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“…[20][21][22] These have broadly supported the hypothesis that patients treated at the latter centres experience more favourable outcomes. As the proportion of physicians with fellowship training at academic institutions is putatively higher at NCI-designated CC, this may facilitate the achievement of superior perioperative outcomes at these centres.…”

Section: Discussionmentioning

confidence: 56%

Perioperative outcomes after radical cystectomy at NCI-designated centres: Are they any better?

Roghmann

Ravi

Hanske

et al. 2015

CUAJ

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Introduction: In 1971, the National Cancer Institute (NCI) introduced a network of NCI-designated Cancer Centers (CC), which underwent a comprehensive approval process relying on research, education and prevention activities. In this study, we examine the effect of CC status on perioperative outcomes after radical cystectomy (RC). Methods: Within the Nationwide Inpatient Sample, we focused on RC performed from 2006 to 2010. As all recognized centres were residency teaching institutions, we stratified according to teaching and CC-teaching status. We examined the rates of in-hospital mortality, intra-and postoperative complications, prolonged length of hospital stay, as well as blood transfusion. Multivariable logistic regression analyses were further adjusted for confounding factors. Results: Overall, 22 840 RC patients (5451 at non-teaching, 10 857 at residency teaching, 6532 at CC-teaching institutions) were identified. Patients treated at residency teaching and CC-teaching institutions were younger, had less comorbidities, and more likely to have private insurance. In multivariable analyses, patients treated at residency and CC-teaching institutions were less likely to experience postoperative complications (odds ratio [OR] 0.73 and 0.66, respectively) and blood transfusions (OR 0.77 and 0.53, respectively) relative to patients treated at non-teaching institutions. In addition, CC patients were also less likely to experience in-hospital mortality (OR 0.61, all p < 0.001) as compared to non-teaching institutions. Conclusions: On average, patients treated at residency and CC-teaching institutions are less likely to experience unfavourable outcomes after RC. Moreover, patients treated at CC fared better than patients treated at residency teaching institutions. Our findings acknowledge the quality of RC care at accredited centres.

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“…However, the USPSTF did not recommend PSA screening for men aged 50–54 years. The USPSTF still overestimated the risk of death as a result of radical prostatectomy, because the recent survey showed that the risk decreased to approximately 0.1% …”

Section: Critical Reviews Of the Uspstf Recommendation In 2012 And 2018mentioning

confidence: 99%

Screening for prostate cancer: History, evidence, controversies and future perspectives toward individualized screening

et al. 2019

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Differences in the incidence and mortality rate of prostate cancer between the USA and Japan have been decreasing over time, and were only twofold in 2017. Therefore, countermeasures against prostate cancer could be very important not only in Western countries, but also in developed Asian countries. Screening for prostate cancer in the general population using transrectal ultrasonography, digital rectal examination and/or prostate acid phosphatase began in Japan in the early 1980s, and screening with prostate‐specific antigen and digital rectal examination has been widespread in the USA since the late 1980s. Large‐ and mid‐scale randomized controlled trials on screening for prostate cancer began around 1990 in the USA, Canada and Europe. However, most of these studies failed as randomized controlled trials because of high contamination in the control arm, low compliance in the screening arm or insufficient screening setting about screening frequency and/or biopsy indication. The best available level 1 evidence is data from the European Randomized Study of Screening for Prostate Cancer and the Göteborg screening study. However, several non‐urological organizations and lay media around the world have mischaracterized the efficacy of prostate‐specific antigen screening. To avoid long‐term confusion about screening for prostate cancer, leading professional urological organizations, including the Japanese Urological Association, are moving toward the establishment of an optimal screening system that minimizes the drawbacks of overdetection, overtreatment and loss of quality of life due to treatment, and maximizes reductions in the risk of death as a result of prostate cancer and the development of metastatic prostate cancer.

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The impact of hospital volume, residency, and fellowship training on perioperative outcomes after radical prostatectomy

Cited by 37 publications

References 23 publications

Prostate Cancer Registries: Current Status and Future Directions

Prostate Cancer Registries: Current Status and Future Directions

Perioperative outcomes after radical cystectomy at NCI-designated centres: Are they any better?

Screening for prostate cancer: History, evidence, controversies and future perspectives toward individualized screening

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