PURPOSE: Radical prostatectomy (RP) is a common treatment for organ-confined prostate cancer and its utilization is increasing.
We examined how the increased volume is being distributed and what hospital characteristics are associated with increasing volume.
MATERIALS AND METHODS: We identified all men ≥40 and ≤ 80 years old that underwent RP for prostate cancer from 2000-2008 in the Nationwide Inpatient Sample (n=586,429). Ownership of a surgical robot was determined using the 2007 American Hospital Association Annual Survey. The association between hospital RP volume and hospital characteristics, including ownership of a robot, was explored using multivariate linear regression.
RESULTS: From 2000 to 2008, there was a 74% increase in the number of RPs performed (p=0.05) along with a 19% decrease in the number of hospitals performing RP (p< 0.001) resulting in an increase in annual hospital RP volume (p=0.009). Several hospital variables were associated higher RP volume including teaching status, urban location, large bed size and ownership of a robot in 2007. On multivariate analysis, year, teaching status, large bed size, urban location and presence of a robot were associated with higher hospital RP volume.
CONCLUSIONS: Utilization of RP increased significantly between 2000 and 2008, most notably after 2005. The increase in RP resulted in centralization to select hospitals, particularly those in the top RP volume quartile and those investing in robotic technology. Our findings support the hypothesis that hospitals with the greatest volume increases were specialty centers already performing a high volume of RP.
Written by:
Anderson CB, Penson DF, Ni S, Makarov DV, Barocas DA. Are you the author?
Vanderbilt University Medical Center, Department of Urologic Surgery, Nashville, TN.
Reference: J Urol. 2012 Oct 12. pii: S0022-5347(12)05193-2.
doi: 10.1016/j.juro.2012.10.012
PubMed Abstract
PMID: 23069384
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