Successful prostate surgery: It's quality of surgery not quantity that matters most

Copenhagen, Denmark: A surgeon's personal skill in performing radical prostate surgery and not necessarily the number of operations performed is the key to a patient's future quality of life and the potential for cure. Surgeons must be honest with patients about their own success rates and prospective patients should not be afraid to ask tough questions, a leading urologist said today (Monday 22 September).

Professor Hendrik Van Poppel told ECCO 12 The European Cancer Conference that his research showed that contrary to what might be expected, expertise is not necessarily linked to the number of radical prostectomies a surgeon performs.

Professor Van Poppel, chairman at the Department of Urology at Gasthuisberg Katholieke Universiteit in Leuven, Belgium, said that the quality of surgery was evaluated of 27 surgeons in 23 centres that were part of the European Organisation and Research and Treatment of Cancer (EORTC) Genito-Urinary Group.

He said that it was perfectly possible to use a checklist to look retrospectively for the quality of a particular surgeon. A few parameters could determine quality.

The parameters used were length of surgery, blood loss, postoperative continence, the pathological status of the resection margins and the rate of undetectable PSA (prostate specific antigen) after surgery. The survey related the results from over 230 radical prostectomies to the annual number of these operations performed, classified in five categories ranging from more than 50 a year to less than five a year.

"What we found was that these parameters varied considerably and cannot be absolutely related to caseload. Indeed, we saw that some centres with a high caseload did not have better oncological or urological results. It really does depend on the skill of individual surgeons."

Although many patients in eastern Europe and the former USSR are still not diagnosed until the cancer had spread, in western Europe 80% are

Contact: Emma Mason
Federation of European Cancer Societies

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