Initial experience of Da Vinci robotic thoracic surgery at the First Affiliated Hospital of Zhejiang University

He, Zhehao; Zeng, Liping; Zhang, Chong; Wang, Luming; Wang, Zhitian; Rustam, Azmat; Du, Chengli; Lv, Wang; Hu, Jian

doi:10.21037/jovs.2017.09.11

Cited by 1 publication

(2 citation statements)

References 16 publications

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“…According to Intuitive Surgical records, more than 2,400 surgical cases were completed at First Affiliated Hospital of Zhejiang University using the Da Vinci system. Indeed, as use increased, our center set a world record, 836 cases, in 2015 for single-unit use, which was broken when our center reached 888 cases in 2016 8 . Furthermore, robot-assisted RP is safe in men >75 years of age and has low complication rates, good oncologic and continence outcomes, and reasonable potency outcomes 19 .…”

Section: Discussionmentioning

confidence: 99%

“…Our hospital (the First Affiliated Hospital, College of Medicine, Zhejiang University) ranks among China's top 10 hospitals and is the largest medical center in Zhejiang Province. In particular, the urology department of our hospital is ranked the number 1 in Zhejiang both in terms of the number of patients (e.g., Da Vinci surgical urological cases for 2016 and 2017 ranked among the top 3 in China) and treatment technologies (the fourth generation Da Vinci's robotic system) 8 . Clearly, the medical database of the hospital is quite valuable for PCSs of PCa in China and represents a real-world situation in China.…”

Section: Introductionmentioning

confidence: 99%

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Trends in Treatment for Prostate Cancer in China: Preliminary Patterns of Care Study in a Single Institution

et al. 2018

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Objectives: A Patterns of Care Study (PCS) was performed in the largest regional medical center in Zhejiang Province, China. The hospital information system (HIS) was used to evaluate patient characteristics and changes in initial treatment patterns for prostate cancer and to determine recent predominant trends in treatment plans for prostate cancer (PCa) in China.Methods: Men who were newly diagnosed with localized or locally advanced PCa for 2010-2011 and 2016-2017 were identified in the HIS database. Patient characteristics and temporal trends in initial management were assessed, and differences between groups were evaluated for significance using Chi-square and Mann-Whitney U tests.Results: In total, 1792 patients met the study criteria, including 505 and 1287 patients in the 2010-2011 and 2016-2017 samples, respectively. The average age of patients diagnosed in the 2010-2011 PCS survey was 70 years, decreasing to 68 years when the 2016-2017 patients were included (P<0.001). In the 2010-2011 sample, 50.69% of the patients had an initial prostate-specific antigen (PSA) level ≥20 ng/ml. In contrast, the initial PSA level was 4-19.99 ng/ml for 66.67% of the patients in the 2016-2017 sample (P<0.001). Based on National Comprehensive Cancer Network (NCCN) criteria, the percentages of patients in low- and intermediate-risk groups increased from 33.06% to 54.78%; conversely, the percentages in high-risk, very high-risk, and regional (N1) groups decreased to a certain extent (P<0.001). According to European Association of Urology (EAU) criteria, the percentages of patients in low- and intermediate-risk groups increased from 32.07% to 53.69%, yet the percentage in the high-risk group decreased (P<0.001). The use of radical prostatectomy (RP) and radiation therapy (RT) increased from 48.32% to 76.46% and 5.35% to 16.94%, particularly in high-risk and low-risk groups, respectively, whereas the rates of hormone therapy (HT) and active surveillance and observation (AS&O) decreased from 32.28% to 4.27% and from 16.04% to 2.33%, respectively (P<0.001). A similar pattern was observed when patients were stratified by EAU risk group.Conclusions: The results of this real-world study in the largest regional medical center in Zhejiang Province, China, indicate that the predominant characteristics of PCa patients and trends in initial management are changing rapidly. We found the following: (a) a trend toward a decreased age among newly diagnosed patients; (b) a trend toward lower initial PSA levels; (c) a downward trend in risk group classification; (d) a significant increase in the likelihood of receiving RP, particularly in the high-risk group; (e) an increase in the rate of RP, mostly due to use of the Da Vinci robotic system; (f) a significant increase in the likelihood of receiving RT, especially in the low-risk group; and (g) a decrease in HT and AS&O.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%