Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy: Nationwide, population-based study

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Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy : Nationwide, population-based study. / Godtman, Rebecka Arnsrud; Persson, Erik; Cazzaniga, Walter; Sandin, Fredrik; Carlsson, Stefan; Ahlgren, Göran; Johansson, Eva; Robinsson, David; Hugosson, Jonas; Stattin, Pär.

I: PLoS ONE, Vol. 16, Nr. 6 June 2021, e0253081, 2021.

Forskningsoutput: TidskriftsbidragArtikel i vetenskaplig tidskrift

Harvard

Godtman, RA, Persson, E, Cazzaniga, W, Sandin, F, Carlsson, S, Ahlgren, G, Johansson, E, Robinsson, D, Hugosson, J & Stattin, P 2021, 'Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy: Nationwide, population-based study', PLoS ONE, vol. 16, nr. 6 June 2021, e0253081. https://doi.org/10.1371/journal.pone.0253081

APA

Godtman, R. A., Persson, E., Cazzaniga, W., Sandin, F., Carlsson, S., Ahlgren, G., Johansson, E., Robinsson, D., Hugosson, J., & Stattin, P. (2021). Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy: Nationwide, population-based study. PLoS ONE, 16(6 June 2021), [e0253081]. https://doi.org/10.1371/journal.pone.0253081

CBE

Godtman RA, Persson E, Cazzaniga W, Sandin F, Carlsson S, Ahlgren G, Johansson E, Robinsson D, Hugosson J, Stattin P. 2021. Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy: Nationwide, population-based study. PLoS ONE. 16(6 June 2021):Article e0253081. https://doi.org/10.1371/journal.pone.0253081

MLA

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Author

Godtman, Rebecka Arnsrud ; Persson, Erik ; Cazzaniga, Walter ; Sandin, Fredrik ; Carlsson, Stefan ; Ahlgren, Göran ; Johansson, Eva ; Robinsson, David ; Hugosson, Jonas ; Stattin, Pär. / Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy : Nationwide, population-based study. I: PLoS ONE. 2021 ; Vol. 16, Nr. 6 June 2021.

RIS

TY - JOUR

T1 - Association of surgeon and hospital volume with short-term outcomes after robotassisted radical prostatectomy

T2 - Nationwide, population-based study

AU - Godtman, Rebecka Arnsrud

AU - Persson, Erik

AU - Cazzaniga, Walter

AU - Sandin, Fredrik

AU - Carlsson, Stefan

AU - Ahlgren, Göran

AU - Johansson, Eva

AU - Robinsson, David

AU - Hugosson, Jonas

AU - Stattin, Pär

PY - 2021

Y1 - 2021

N2 - Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11-11.91), hospital (OR 2.16, 95% CI 1.53- 3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07-3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34-3.57), hospital (OR 2.02, 95% CI 1.66-2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54-2.35), hospital (OR 1.28, 95% CI 1.07-1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement.

AB - Background and objective Few studies have investigated the association between surgical volume and outcome of robot-assisted radical prostatectomy (RARP) in an unselected cohort. We sought to investigate the association between surgical volume with peri-operative and short-term outcomes in a nation-wide, population-based study group. Methods 9,810 RARP's registered in the National Prostate Cancer Register of Sweden (2015-2018) were included. Associations between outcome and volume were analyzed with multivariable logistic regression including age, PSA-density, number of positive biopsy cores, cT stage, Gleason score, and extent of lymph node dissection. Results Surgeons and hospitals in the highest volume group compared to lowest group had shorter operative time; surgeon (OR 9.20, 95% CI 7.11-11.91), hospital (OR 2.16, 95% CI 1.53- 3.06), less blood loss; surgeon (OR 2.58. 95% CI 2.07-3.21) hospital (no difference), more often nerve sparing intention; surgeon (OR 2.89, 95% CI 2.34-3.57), hospital (OR 2.02, 95% CI 1.66-2.44), negative margins; surgeon (OR 1.90, 95% CI 1.54-2.35), hospital (OR 1.28, 95% CI 1.07-1.53). There was wide range in outcome between hospitals and surgeons with similar volume that remained after adjustment. Conclusions High surgeon and hospital volume were associated with better outcomes. The range in outcome was wide in all volume groups, which indicates that factors besides volume are of importance. Registration of surgical performance is essential for quality control and improvement.

U2 - 10.1371/journal.pone.0253081

DO - 10.1371/journal.pone.0253081

M3 - Article

C2 - 34138904

AN - SCOPUS:85108254865

VL - 16

JO - PLoS ONE

JF - PLoS ONE

SN - 1932-6203

IS - 6 June 2021

M1 - e0253081

ER -