Impact of surgical volume on the rate of lymph node metastases in patients undergoing radical prostatectomy and extended pelvic lymph node dissection for clinically localized prostate cancer.
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Impact of surgical volume on the rate of lymph node metastases in patients undergoing radical prostatectomy and extended pelvic lymph node dissection for clinically localized prostate cancer. / Briganti, Alberto; Capitanio, Umberto; Chun, Felix; Gallina, Andrea; Suardi, Nazareno; Salonia, Andrea; Pozzo, Da; Luigi, F; Colombo, Renzo; Valerio, Di Girolamo; Bertini, Roberto; Guazzoni, Giorgio; Karakiewicz, Pierre I; Montorsi, Francesco; Rigatti, Patrizio.
In: EUR UROL, Vol. 54, No. 4, 4, 2008, p. 794-802.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Impact of surgical volume on the rate of lymph node metastases in patients undergoing radical prostatectomy and extended pelvic lymph node dissection for clinically localized prostate cancer.
AU - Briganti, Alberto
AU - Capitanio, Umberto
AU - Chun, Felix
AU - Gallina, Andrea
AU - Suardi, Nazareno
AU - Salonia, Andrea
AU - Pozzo, Da
AU - Luigi, F
AU - Colombo, Renzo
AU - Valerio, Di Girolamo
AU - Bertini, Roberto
AU - Guazzoni, Giorgio
AU - Karakiewicz, Pierre I
AU - Montorsi, Francesco
AU - Rigatti, Patrizio
PY - 2008
Y1 - 2008
N2 - BACKGROUND: Previous trials have shown that the number of procedures done by a single surgeon, that is, surgical volume (SV), is associated with several outcomes after radical prostatectomy (RP). OBJECTIVE: To test the association between SV and the detection of lymph node metastases during extended pelvic lymph node dissection (ePLND). DESIGN, SETTING, AND PARTICIPANTS: The study cohort consisted of 1020 men surgically treated for clinically localized prostate cancer. INTERVENTION: All patients underwent RP and ePLND by a group of six surgeons who were trained by the surgeon with the highest SV. All surgeons performed an anatomically extended PLND, including removal of obturator, external iliac, and hypogastric nodes. MEASUREMENTS: Univariable and multivariable logistic regression models tested the association between SV (either continuously coded or dichotomized according to the most informative cut-off, namely >144 vs or =0.06). Conversely, the surgeon with the highest SV removed more nodes and found more nodal metastases compared with the other surgeons (21.1 vs 17.9 mean number of nodes removed; p144 ePLNDs) were more likely to have LNI than those treated by low-volume surgeons, even though all surgeons used a similar extended template for node removal.
AB - BACKGROUND: Previous trials have shown that the number of procedures done by a single surgeon, that is, surgical volume (SV), is associated with several outcomes after radical prostatectomy (RP). OBJECTIVE: To test the association between SV and the detection of lymph node metastases during extended pelvic lymph node dissection (ePLND). DESIGN, SETTING, AND PARTICIPANTS: The study cohort consisted of 1020 men surgically treated for clinically localized prostate cancer. INTERVENTION: All patients underwent RP and ePLND by a group of six surgeons who were trained by the surgeon with the highest SV. All surgeons performed an anatomically extended PLND, including removal of obturator, external iliac, and hypogastric nodes. MEASUREMENTS: Univariable and multivariable logistic regression models tested the association between SV (either continuously coded or dichotomized according to the most informative cut-off, namely >144 vs or =0.06). Conversely, the surgeon with the highest SV removed more nodes and found more nodal metastases compared with the other surgeons (21.1 vs 17.9 mean number of nodes removed; p144 ePLNDs) were more likely to have LNI than those treated by low-volume surgeons, even though all surgeons used a similar extended template for node removal.
M3 - SCORING: Zeitschriftenaufsatz
VL - 54
SP - 794
EP - 802
JO - EUR UROL
JF - EUR UROL
SN - 0302-2838
IS - 4
M1 - 4
ER -
