Previous studies have shown that rates of prostate cancer recurrence after open radical prostatectomy decrease significantly with increasing surgeon experience.

In the early online edition of The Lancet Oncology, researchers report that increasing surgical experience is also associated with substantial reductions in prostate cancer recurrence after less-invasive laparoscopic radical prostatectomy.

However, it does seem that surgical expertise seems to accumulate more slowly for laparoscopic radical prostatectomy than for open surgery. Researchers from Memorial Sloan Kettering Cancer Center in New York and their colleagues did a retrospective study of 4702 prostate cancer patients who were treated with laparoscopic surgery by one of 29 surgeons from seven institutions in Europe and North American between January 1998 and June 2007. They found that greater surgeon experience was associated with a lower risk of prostate cancer recurrence. While patients who were treated by a surgeon with 10 prior laparoscopic procedures had a 5-year recurrence risk of 17%, those who were treated by a surgeon with 750 prior laparoscopic procedures had a 5-year recurrence risk of 9%. From this information, the researchers conclude that improvements in outcome seemed to accrue more slowly for laparoscopic surgery than for open surgery.

Interestingly, surgeons who had previous experience with performing open radical prostatectomy had significantly poorer surgical results than those whose first operation was laparoscopic, suggesting that the skills needed for laparoscopic prostatectomy do not translate well from open procedures. For patients with prostate cancer who need surgical intervention, this seems to indicate that knowing your surgeon’s previous experience with the types of procedures for prostate removal may have an important effect on rate of cancer recurrence.

Source:

The Lancet Oncology, Early Online Publication, 1 April 2009.