Prostate Cancer Surgery Success Depends on Surgeon's Experience

As a surgeon gains more experience performing radical prostatectomy, the chance that the patients' prostate cancer will reoccur goes down, stated a new study.

Researchers at the Memorial Sloan-Kettering Cancer Center (New York, NY, USA) analyzed data from 72 surgeons at four institutions and 7,765 of their prostate cancer patients treated with radical prostatectomies between 1987 and 2003. They measured the surgeons' experience by the number of times they had performed the procedure before each operation.

The researchers found that more surgical experience was associated with a greater likelihood that the patient's cancer would not return after their operation, since the learning curve for the procedure was very steep. There was dramatic improvement in patient outcomes as the surgeons' experience increased up to 250 operations, after which increasing experience had little influence on cancer recurrence. Patients treated by inexperienced surgeons--for example, those with 10 prior operations--were nearly 70% more likely to have evidence of recurrence of their prostate cancer within five years than those whose surgeons had performed 250 operations (17.9% vs. 10.7%). The study was published online on July 24, 2007 in the Journal of the U.S. National Cancer Institute.

"Our findings also have implications for education in surgical oncology. Although the successful practice of surgery necessarily presumes a lifetime of learning, the large number of cases required before the learning curve plateaus suggests the need to expand opportunities for training in surgical technique for surgeons in the early years after residency training,” concluded lead author Andrew Vickers, Ph.D., and colleagues.


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Memorial Sloan-Kettering Cancer Center