Patterns of Care, Utilization, and Outcomes of Treatments for Localized Prostate Cancer

Abstract

Abstract : The purpose of the research is to characterize patterns of care, utilization, and outcomes of treatments for localized prostate cancer such as surgery, external beam radiation, and brachytherapy. In particular, the research characterizes the patterns of care, utilization and outcomes of minimally invasive radical prostatectomy (MIRP) versus open retropubic radical prostatectomy (RRP). MIRP utilization increased from 9% to 43% from 2003 to 2007. Lengths of stay, transfusions, and stricture rates are lower for MIRP vs. RRP. However, erectile dysfunction and incontinence were more frequently diagnosed postoperatively. Additionally positive surgical margins were similar by surgical approach. While higher RRP surgeon volume was associated with fewer complications, this was not observed for MIRP surgeon volume and outcomes. In addition, MIRP was $293 more costly than RRP. Finally, pelvic lymph node dissection was performed less frequently with MIRP vs. RRP.