337 CONTEMPORARY OPEN AND ROBOTIC RADICAL PROSTATECTOMY PRACTICE PATTERNS AMONG UNITED STATES UROLOGISTS

Abstract

You have accessJournal of UrologyProstate Cancer: Epidemiology and Natural History1 Apr 2011337 CONTEMPORARY OPEN AND ROBOTIC RADICAL PROSTATECTOMY PRACTICE PATTERNS AMONG UNITED STATES UROLOGISTS William Lowrance, James Eastham, Caroline Savage, Vincent Laudone, Peter Scardino, and Jaspreet Sandhu William LowranceWilliam Lowrance New York, NY More articles by this author , James EasthamJames Eastham New York, NY More articles by this author , Caroline SavageCaroline Savage New York, NY More articles by this author , Vincent LaudoneVincent Laudone New York, NY More articles by this author , Peter ScardinoPeter Scardino New York, NY More articles by this author , and Jaspreet SandhuJaspreet Sandhu New York, NY More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2011.02.421AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES There are few reports detailing current radical prostatectomy (RP) practice patterns in the United States (US). We aimed to describe the trends in robotic and open RP use by examining case logs submitted for American Board of Urology (ABU) certification. We also examined the impact of surgeon age on those practice patterns. METHODS US urologists must submit case logs for their initial board certification and recertification. We analyzed these logs from 2004 through 2010 for trends and used logistic regression to assess the impact of age on robotic RP utilization. RESULTS In total 4,303 urologists submitted case logs for certification between 2004 and 2010. Of these, 3,374 included ≥1 RP case, of which 961 (28%) reported performing ≥1 robotic RP and 2,413 (72%) reported exclusively open cases; 308 (9%) surgeons reported performing exclusively robotic RP. We observed a large increase in the number and proportion of urologists performing robotic RP and a smaller corresponding decrease in those performing open RP. In 2004, only 8% of patients received a robotic RP by certifying urologists; in 2010 67% did (Table). Median age for urologists performing exclusively open RP was 43 years (interquartile range (IQR): 38, 51) compared to 41 years (IQR: 35, 46) for those performing only robotic RP. Compared to their younger colleagues, older urologists were significantly less likely to perform ≥1 robotic RP when undergoing their first or second recertification (odds ratio [OR] per year: 0.94; p=0.013 and OR per year: 0.92; p=0.018, respectively), but not their initial certification (OR per year: 0.98; p=0.3). Number (proportion) of patients receiving either open or robotic radical prostatectomy by year of urologist certification or recertification (N=67,178) No. Urologists No. Patients Open RP Robotic RP 2004 427 6,188 5,690(92%) 498(8%) 2005 421 6,692 5,512(82%) 1,180(18%) 2006 531 9,494 7,032(74%) 2,462(26%) 2007 520 10,110 6,092(60%) 4,018(40%) 2008 459 11,000 5,344(49%) 5,656(51%) 2009 516 12,404 4,500(36%) 7,904(64%) 2010 500 11,290 3,770(33%) 7,520(67%) Total 3,374 67,178 37,940 29,238 CONCLUSIONS In contrast to industry estimates of 80%, we found that, among urologists undergoing board certification or recertification in 2010, only 67% of RP were done robotically. We also found that older age was significantly associated with lower likelihood of performing robotic RP among those recertifying. These data provide non-industry-based estimates of current RP practice patterns and further our understanding of the evolving surgical treatment of prostate cancer. © 2011 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byAnderson C, Penson D, Ni S, Makarov D and Barocas D (2012) Centralization of Radical Prostatectomy in the United StatesJournal of Urology, VOL. 189, NO. 2, (500-506), Online publication date: 1-Feb-2013. Volume 185Issue 4SApril 2011Page: e136 Advertisement Copyright & Permissions© 2011 by American Urological Association Education and Research, Inc.MetricsAuthor Information William Lowrance New York, NY More articles by this author James Eastham New York, NY More articles by this author Caroline Savage New York, NY More articles by this author Vincent Laudone New York, NY More articles by this author Peter Scardino New York, NY More articles by this author Jaspreet Sandhu New York, NY More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...