UroToday – Prostate Cancer Surgery Outcomes: Surgeon Dependent Factors
“Subgroup analysis showed superior recurrence free survival for patients treated by surgeons with greater than 1,000 operations compared to less than 50 operations. After 250 surgeries, the curves plateau.”
This was a presentation by one of the worlds best prostate cancer surgeons, Dr. Peter Scardino.
Pertinent findings were that surgeon volume was a factor in outcomes, as was surgeon technique.
The number of cases that we do can not be changed, but technique can be improved. With robotics I think the learning curve can be somewhat quickened by reviewing surgeries on video. Ive found it helpful to review DVDs of robotic surgeries from such experts as Dr. Patel and Dr. Ahlering and review my own DVDs on cases that were difficult.
I also think it is important for surgeons to keep a database to see how they are doing and if anything can be fixed. In my robotic series, the outcomes have improved for the first 75 or so, but have been fairly stable since then over the last 100+. I think the most important reasons to have a relatively quick learning curve were my previous open prostate cancer experience of over 100 operations, as well as viewing expert video and my own video.