Hospital volume and outcomes after radical prostatectomy: a national population-based study using patient-reported urinary continence and sexual function
Cowling, T. E.
Parry, M. G.
van der Meulen, J.
Clarke, Noel W
AffiliationDepartment of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
MetadataShow full item record
AbstractBackground: Improvements in short-term outcomes have been reported for hospitals with higher radical prostatectomy (RP) volumes. However, the association with longer-term functional outcomes is unknown. Methods: All patients diagnosed with non-metastatic prostate cancer in the English NHS between 2014 and 2016 who underwent RP (N = 10,089) were mailed a survey ≥18 months after diagnosis. Differences in patient-reported urinary continence and sexual function (EPIC-26 on scale from 0 to 100) by hospital volume group (≤60, 61-100, 101-140, >140 RPs/year) were estimated using multilevel linear regression. Results: Overall, 7702 men (76.3%) responded. There were no statistically significant differences in urinary continence (p = 0.08) or sexual function scores with increasing volume group (p = 0.2). When modelled as a linear function, we found a non-significant increase of 0.70 (95% CI -0.41 to 1.80; p = 0.22) in urinary continence and a significant increase of 1.54 (0.62-2.45; p = 0.001) in sexual function scores for a 100-procedure increase in hospital volume, which did not meet the threshold for a minimal clinically important difference (10-12 points). The results were similar for robotic-assisted RP (5529 men [71.8%]). Conclusions: These results do not support further centralisation of RP services beyond levels in England where four in five hospitals perform >60 RPs/year.
CitationNossiter J, Morris M, Cowling TE, Parry MG, Sujenthiran A, Aggarwal A, et al. Hospital volume and outcomes after radical prostatectomy: a national population-based study using patient-reported urinary continence and sexual function. Prostate Cancer Prostatic Dis. 2021 Sep 8.
JournalProstate Cancer and Prostatic Diseases
- Robot-assisted radical prostatectomy vs laparoscopic and open retropubic radical prostatectomy: functional outcomes 18 months after diagnosis from a national cohort study in England.
- Authors: Nossiter J, Sujenthiran A, Charman SC, Cathcart PJ, Aggarwal A, Payne H, Clarke NW, van der Meulen J
- Issue date: 2018 Feb 20
- The impact of anterior urethropexy during robotic prostatectomy on urinary and sexual outcomes.
- Authors: Johnson EK, Hedgepeth RC, He C, Wood DP Jr
- Issue date: 2011 Apr
- Radical prostatectomy versus deferred treatment for localised prostate cancer.
- Authors: Vernooij RW, Lancee M, Cleves A, Dahm P, Bangma CH, Aben KK
- Issue date: 2020 Jun 4
- Urinary function after radical prostatectomy: a comparison of the retropubic and perineal approaches.
- Authors: Gray M, Petroni GR, Theodorescu D
- Issue date: 1999 May
- Association Between Radiation Therapy, Surgery, or Observation for Localized Prostate Cancer and Patient-Reported Outcomes After 3 Years.
- Authors: Barocas DA, Alvarez J, Resnick MJ, Koyama T, Hoffman KE, Tyson MD, Conwill R, McCollum D, Cooperberg MR, Goodman M, Greenfield S, Hamilton AS, Hashibe M, Kaplan SH, Paddock LE, Stroup AM, Wu XC, Penson DF
- Issue date: 2017 Mar 21