The impact of fellowship training on pathological outcomes following radical prostatectomy: a population based analysis
Radical prostatectomy (RP) is a common treatment for prostate cancer (PCa). Morbidity, mortality and pathological outcomes may be superior in academic institutions. One explanation may be the involvement of oncology fellowship trained urologists within academic institutions. The literature examining...
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| Veröffentlicht in: | BMC urology 2014-10, Vol.14 (1), p.82-82, Article 82 |
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| creator | Nayak, Jasmir G Drachenberg, Darrel E Mau, Elke Suderman, Derek Bucher, Oliver Lambert, Pascal Quon, Harvey |
| description | Radical prostatectomy (RP) is a common treatment for prostate cancer (PCa). Morbidity, mortality and pathological outcomes may be superior in academic institutions. One explanation may be the involvement of oncology fellowship trained urologists within academic institutions. The literature examining pathological outcomes often lacks individual surgeon data. The objective of this study was to compare pathological outcomes following RP between fellowship trained and non-fellowship trained urologists.
Population-based, retrospective chart review of men diagnosed with PCa between 2003 and 2008, the majority treated with open approach RP (>99%). Pathological outcomes were compared between oncology fellowship trained academic (FTA), non-fellowship trained academic (NFTA) and non-academic (NA) urologists. Relationships with pathological outcomes were examined utilizing multivariable logistic regression.
83.1% of eligible patients were included in our analysis resulting in 1075 patients. In multivariable analysis, surgeon group was an independent predictor of positive surgical margin (PSM) (p |
| doi_str_mv | 10.1186/1471-2490-14-82 |
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Population-based, retrospective chart review of men diagnosed with PCa between 2003 and 2008, the majority treated with open approach RP (>99%). Pathological outcomes were compared between oncology fellowship trained academic (FTA), non-fellowship trained academic (NFTA) and non-academic (NA) urologists. Relationships with pathological outcomes were examined utilizing multivariable logistic regression.
83.1% of eligible patients were included in our analysis resulting in 1075 patients. In multivariable analysis, surgeon group was an independent predictor of positive surgical margin (PSM) (p < 0.0001). NFTA and NA urologists were more likely to have PSM compared to FTA urologists (OR 2.50; 95% CI: 1.44-4.35 and OR 2.10; 95% CI: 1.53-2.88, respectively). However, the proportion of PSM between NFTA and NA urologists was not significant (p = 0.492). In addition, pathological stage (p = 0.0004), Gleason sum (p < 0.0001), and surgeon volume (p = 0.017) were associated with PSM. Limitations include retrospective design and lack of clinical and functional outcomes.
Uro-oncology fellowship trained surgeons had significantly lower rates of PSM than non-fellowship trained surgeons in this population based cohort. This study demonstrates the importance of surgeon-related variables on pathological outcomes and highlights the value of additional urologic oncology fellowship training.</description><identifier>ISSN: 1471-2490</identifier><identifier>EISSN: 1471-2490</identifier><identifier>DOI: 10.1186/1471-2490-14-82</identifier><identifier>PMID: 25339410</identifier><language>eng</language><publisher>England: BioMed Central Ltd</publisher><subject>Accreditation ; Adenocarcinoma - pathology ; Adenocarcinoma - surgery ; Aged ; Antigens ; Cancer ; Care and treatment ; Clinical Competence ; Fellowships and Scholarships ; Hospitals ; Humans ; Male ; Middle Aged ; Neoplasm Grading ; Neoplasm Recurrence, Local - pathology ; Neoplasm Staging ; Oncology ; Population ; Prostate - pathology ; Prostate - surgery ; Prostate cancer ; Prostatectomy ; Prostatic Neoplasms - pathology ; Prostatic Neoplasms - surgery ; Retrospective Studies ; Statistical analysis ; Studies ; Surgery ; Urology ; Urology - education ; Variables</subject><ispartof>BMC urology, 2014-10, Vol.14 (1), p.82-82, Article 82</ispartof><rights>COPYRIGHT 2014 BioMed Central Ltd.</rights><rights>2014 Nayak et al.; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.</rights><rights>Nayak et al.; licensee BioMed Central Ltd. 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b547t-622ffe53cf612a1d8fc3d184c504420ca74108e69abaae548374e40dea16094b3</citedby><cites>FETCH-LOGICAL-b547t-622ffe53cf612a1d8fc3d184c504420ca74108e69abaae548374e40dea16094b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216843/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216843/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25339410$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nayak, Jasmir G</creatorcontrib><creatorcontrib>Drachenberg, Darrel E</creatorcontrib><creatorcontrib>Mau, Elke</creatorcontrib><creatorcontrib>Suderman, Derek</creatorcontrib><creatorcontrib>Bucher, Oliver</creatorcontrib><creatorcontrib>Lambert, Pascal</creatorcontrib><creatorcontrib>Quon, Harvey</creatorcontrib><title>The impact of fellowship training on pathological outcomes following radical prostatectomy: a population based analysis</title><title>BMC urology</title><addtitle>BMC Urol</addtitle><description>Radical prostatectomy (RP) is a common treatment for prostate cancer (PCa). Morbidity, mortality and pathological outcomes may be superior in academic institutions. One explanation may be the involvement of oncology fellowship trained urologists within academic institutions. The literature examining pathological outcomes often lacks individual surgeon data. The objective of this study was to compare pathological outcomes following RP between fellowship trained and non-fellowship trained urologists.
Population-based, retrospective chart review of men diagnosed with PCa between 2003 and 2008, the majority treated with open approach RP (>99%). Pathological outcomes were compared between oncology fellowship trained academic (FTA), non-fellowship trained academic (NFTA) and non-academic (NA) urologists. Relationships with pathological outcomes were examined utilizing multivariable logistic regression.
83.1% of eligible patients were included in our analysis resulting in 1075 patients. In multivariable analysis, surgeon group was an independent predictor of positive surgical margin (PSM) (p < 0.0001). NFTA and NA urologists were more likely to have PSM compared to FTA urologists (OR 2.50; 95% CI: 1.44-4.35 and OR 2.10; 95% CI: 1.53-2.88, respectively). However, the proportion of PSM between NFTA and NA urologists was not significant (p = 0.492). In addition, pathological stage (p = 0.0004), Gleason sum (p < 0.0001), and surgeon volume (p = 0.017) were associated with PSM. Limitations include retrospective design and lack of clinical and functional outcomes.
Uro-oncology fellowship trained surgeons had significantly lower rates of PSM than non-fellowship trained surgeons in this population based cohort. This study demonstrates the importance of surgeon-related variables on pathological outcomes and highlights the value of additional urologic oncology fellowship training.</description><subject>Accreditation</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - surgery</subject><subject>Aged</subject><subject>Antigens</subject><subject>Cancer</subject><subject>Care and treatment</subject><subject>Clinical Competence</subject><subject>Fellowships and Scholarships</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Grading</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Neoplasm Staging</subject><subject>Oncology</subject><subject>Population</subject><subject>Prostate - pathology</subject><subject>Prostate - surgery</subject><subject>Prostate cancer</subject><subject>Prostatectomy</subject><subject>Prostatic Neoplasms - pathology</subject><subject>Prostatic Neoplasms - surgery</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Studies</subject><subject>Surgery</subject><subject>Urology</subject><subject>Urology - education</subject><subject>Variables</subject><issn>1471-2490</issn><issn>1471-2490</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp1kktv1DAUhSMEog9Ys0OW2LBJ61c8DgukUpWHVIlNWVs3jj3jKskNsUM1_x6nU4YOKvLClu_xd32OXRRvGD1jTKtzJles5LKmJZOl5s-K4_3O80fro-IkxltK2UpX6mVxxCshasnocXF3s3Ek9CPYRNAT77oO7-ImjCRNEIYwrAkOZIS0wQ7XwUJHcE4WexeJx0W8SCZo70vjhDFBcjZhv_1AgIw4zh2kkBkNRNcSGKDbxhBfFS88dNG9fphPix-fr24uv5bX3798u7y4LptKrlKpOPfeVcJ6xTiwVnsrWqalraiUnFpYZRfaqRoaAFdJLVbSSdo6YIrWshGnxccdd5yb3rXWDdlXZ8Yp9DBtDUIwh5UhbMwafxnJmdJSZMCnHaAJ-B_AYSVnY5bgzRJ8XhnNM-T9wy0m_Dm7mEwfos1Zw-BwjoYpVgtOKa2z9N0_0lucp5zavUrXKlPZX9UaOmfC4DH3tgvUXFSirjJNLW3PnlDl0bo-WBycD3n_4MD57oDNDxkn5_c-WbaSP9wTzt4-znev__PDxG9bztJ-</recordid><startdate>20141023</startdate><enddate>20141023</enddate><creator>Nayak, Jasmir G</creator><creator>Drachenberg, Darrel E</creator><creator>Mau, Elke</creator><creator>Suderman, Derek</creator><creator>Bucher, Oliver</creator><creator>Lambert, Pascal</creator><creator>Quon, Harvey</creator><general>BioMed Central Ltd</general><general>BioMed Central</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QP</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20141023</creationdate><title>The impact of fellowship training on pathological outcomes following radical prostatectomy: a population based analysis</title><author>Nayak, Jasmir G ; 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Morbidity, mortality and pathological outcomes may be superior in academic institutions. One explanation may be the involvement of oncology fellowship trained urologists within academic institutions. The literature examining pathological outcomes often lacks individual surgeon data. The objective of this study was to compare pathological outcomes following RP between fellowship trained and non-fellowship trained urologists.
Population-based, retrospective chart review of men diagnosed with PCa between 2003 and 2008, the majority treated with open approach RP (>99%). Pathological outcomes were compared between oncology fellowship trained academic (FTA), non-fellowship trained academic (NFTA) and non-academic (NA) urologists. Relationships with pathological outcomes were examined utilizing multivariable logistic regression.
83.1% of eligible patients were included in our analysis resulting in 1075 patients. In multivariable analysis, surgeon group was an independent predictor of positive surgical margin (PSM) (p < 0.0001). NFTA and NA urologists were more likely to have PSM compared to FTA urologists (OR 2.50; 95% CI: 1.44-4.35 and OR 2.10; 95% CI: 1.53-2.88, respectively). However, the proportion of PSM between NFTA and NA urologists was not significant (p = 0.492). In addition, pathological stage (p = 0.0004), Gleason sum (p < 0.0001), and surgeon volume (p = 0.017) were associated with PSM. Limitations include retrospective design and lack of clinical and functional outcomes.
Uro-oncology fellowship trained surgeons had significantly lower rates of PSM than non-fellowship trained surgeons in this population based cohort. This study demonstrates the importance of surgeon-related variables on pathological outcomes and highlights the value of additional urologic oncology fellowship training.</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>25339410</pmid><doi>10.1186/1471-2490-14-82</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Accreditation Adenocarcinoma - pathology Adenocarcinoma - surgery Aged Antigens Cancer Care and treatment Clinical Competence Fellowships and Scholarships Hospitals Humans Male Middle Aged Neoplasm Grading Neoplasm Recurrence, Local - pathology Neoplasm Staging Oncology Population Prostate - pathology Prostate - surgery Prostate cancer Prostatectomy Prostatic Neoplasms - pathology Prostatic Neoplasms - surgery Retrospective Studies Statistical analysis Studies Surgery Urology Urology - education Variables |
| title | The impact of fellowship training on pathological outcomes following radical prostatectomy: a population based analysis |
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