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. 2014 Oct 23:14:82.
doi: 10.1186/1471-2490-14-82.

The impact of fellowship training on pathological outcomes following radical prostatectomy: a population based analysis

Jasmir G Nayak, Darrel E Drachenberg, Elke Mau, Derek Suderman, Oliver Bucher, Pascal Lambert, Harvey Quon  1
Affiliations

The impact of fellowship training on pathological outcomes following radical prostatectomy: a population based analysis

Jasmir G Nayak et al. BMC Urol. .

Abstract

Background: Radical prostatectomy (RP) is a common treatment for prostate cancer (PCa). Morbidity, mortality and pathological outcomes may be superior in academic institutions. One explanation may be the involvement of oncology fellowship trained urologists within academic institutions. The literature examining pathological outcomes often lacks individual surgeon data. The objective of this study was to compare pathological outcomes following RP between fellowship trained and non-fellowship trained urologists.

Methods: Population-based, retrospective chart review of men diagnosed with PCa between 2003 and 2008, the majority treated with open approach RP (>99%). Pathological outcomes were compared between oncology fellowship trained academic (FTA), non-fellowship trained academic (NFTA) and non-academic (NA) urologists. Relationships with pathological outcomes were examined utilizing multivariable logistic regression.

Results: 83.1% of eligible patients were included in our analysis resulting in 1075 patients. In multivariable analysis, surgeon group was an independent predictor of positive surgical margin (PSM) (p < 0.0001). NFTA and NA urologists were more likely to have PSM compared to FTA urologists (OR 2.50; 95% CI: 1.44-4.35 and OR 2.10; 95% CI: 1.53-2.88, respectively). However, the proportion of PSM between NFTA and NA urologists was not significant (p = 0.492). In addition, pathological stage (p = 0.0004), Gleason sum (p < 0.0001), and surgeon volume (p = 0.017) were associated with PSM. Limitations include retrospective design and lack of clinical and functional outcomes.

Conclusions: Uro-oncology fellowship trained surgeons had significantly lower rates of PSM than non-fellowship trained surgeons in this population based cohort. This study demonstrates the importance of surgeon-related variables on pathological outcomes and highlights the value of additional urologic oncology fellowship training.

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References

    1. Canadian Cancer Statistics 2014.http://www.cancer.ca/~/media/cancer.ca/CW/cancer%20information/cancer%20...
    1. Cancer Facts & Figures 2014.http://www.cancer.org/acs/groups/content/@research/documents/webcontent/...
    1. Begg CB, Cramer LD, Hoskins WJ, Brennan MF. Impact of hospital volume on operative mortality for major cancer surgery. JAMA. 1998;280:1747–1751. doi: 10.1001/jama.280.20.1747. - DOI - PubMed
    1. Ellison LM, Heaney JA, Birkmeyer JD. The effect of hospital volume on mortality and resource use after radical prostatectomy. J Urol. 2000;163:867–869. doi: 10.1016/S0022-5347(05)67821-4. - DOI - PubMed
    1. Begg CB, Riedel ER, Bach PB, Kattan MW, Schrag D, Warren JL, Scardino PT. Variations in morbidity after radical prostatectomy. N Engl J Med. 2002;346:1138–1144. doi: 10.1056/NEJMsa011788. - DOI - PubMed
Pre-publication history
    1. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2490/14/82/prepub