uu.seUppsala University Publications
Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Effects of surgeon variability on oncologic and functional outcomes in a population-based setting
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences.
Show others and affiliations
2014 (English)In: BMC Urology, ISSN 1471-2490, E-ISSN 1471-2490, Vol. 14, 25- p.Article in journal (Refereed) Published
Abstract [en]

Background: Oncologic and functional outcomes after radical prostatectomy (RP) can vary between surgeons to a greater extent than is expected by chance. We sought to examine the effects of surgeon variation on functional and oncologic outcomes for patients undergoing RP for prostate cancer in a European center. Methods: The study comprised 1,280 men who underwent open retropubic RP performed by one of nine surgeons at an academic institution in Sweden between 2001 and 2008. Potency and continence outcomes were measured preoperatively and 18 months postoperatively by patient-administered questionnaires. Biochemical recurrence (BCR) was defined as a prostate-specific antigen (PSA) value > 0.2 ng/mL with at least one confirmatory rise. Multivariable random effect models were used to evaluate heterogeneity between surgeons, adjusting for case mix (age, PSA, pathological stage and grade), year of surgery, and surgical experience. Results: Of 679 men potent at baseline, 647 provided data at 18 months with 122 (19%) reporting potency. We found no evidence for heterogeneity of potency outcomes between surgeons (P = 1). The continence rate for patients at 18 months was 85%, with 836 of the 979 patients who provided data reporting continence. There was statistically significant heterogeneity between surgeons (P = 0.001). We did not find evidence of an association between surgeons' adjusted probabilities of functional recovery and 5-year probability of freedom from BCR. Conclusions: Our data support previous studies regarding a large heterogeneity among surgeons in continence outcomes for patients undergoing RP. This indicates that some patients are receiving sub-optimal care. Quality assurance measures involving performance feedback, should be considered. When surgeons are aware of their outcomes, they can improve them to provide better care to patients.

Place, publisher, year, edition, pages
2014. Vol. 14, 25- p.
Keyword [en]
Prostate cancer, Radical prostatectomy, Erectile function, Urinary function
National Category
Urology and Nephrology
Identifiers
URN: urn:nbn:se:uu:diva-224923DOI: 10.1186/1471-2490-14-25ISI: 000334542600001OAI: oai:DiVA.org:uu-224923DiVA: diva2:720119
Available from: 2014-05-28 Created: 2014-05-23 Last updated: 2017-12-05Bibliographically approved

Open Access in DiVA

fulltext(575 kB)177 downloads
File information
File name FULLTEXT01.pdfFile size 575 kBChecksum SHA-512
8d4cf5303619460908d1bc5025b1d9ddc97fbcf13550b8e12a74f58a8b35b78dc65d7491b7827cc59b09c6fce0a36dd97fb80891ec9f436d6c33cadbc49c67b8
Type fulltextMimetype application/pdf

Other links

Publisher's full text
By organisation
Department of Surgical Sciences
In the same journal
BMC Urology
Urology and Nephrology

Search outside of DiVA

GoogleGoogle Scholar
Total: 177 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

doi
urn-nbn

Altmetric score

doi
urn-nbn
Total: 750 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf