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Impact of fellowship training on pathologic outcomes and complication rates of radical prostatectomy.
Cancer. 2006 Jul 01; 107(1):54-9.C

Abstract

BACKGROUND

The study was conducted to assess the results of radical prostatectomy (RP) performed by fellowship-trained surgeons in the first year of independent practice.

METHODS

A prospective cohort study of 66 men who underwent RP performed by 2 recently graduated fellowship-trained surgeons (C.J.R., n = 27; A.M.K., n = 39) in their first year of independent practice was undertaken. Preoperative, operative, and postoperative data were collected and analyzed. Median follow-up of the cohort is 12.5 months.

RESULTS

The median patient age was 61.2 +/- 6.9 years (range, 44-74 years), the median prostate-specific antigen level was 5 ng/mL (range, 1.2-39.4 ng/mL), and the median prostate biopsy-determined Gleason score was 7. Of the 66 men, 25 (38%) underwent a bilateral nerve-sparing RP, 20 (30%) underwent a unilateral nerve-sparing RP, and 21 (32%) underwent a nonnerve-sparing procedure. Forty-two men (63%) underwent a pelvic lymph node dissection. The median operative time was 201 minutes. Median estimated blood loss was 734 mL (range, 300-1600 mL). There were 4 major complications--a pulmonary embolism in 3 patients and an intraoperative rectal injury in 1. Pathologic classification was as follows: pT2, 74%; pT3a, 23%; pT3b, 2%; and pN+, 2%. The positive margin rate was 14% overall and only 2% in men with pT2 disease.

CONCLUSIONS

Results of RP performed by fellowship-trained surgeons in their first year of practice compare favorably with results of RP in a large series reported by more experienced surgeons. Being trained in an environment where an experienced surgeon serves as first assistant to the trainee appears to abbreviate the learning curve associated with this procedure.

Authors+Show Affiliations

Division of Urology, University of Florida, Jacksonville, Florida 32209, USA. charles.rosser@jax.ufl.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16708356

Citation

Rosser, Charles J., et al. "Impact of Fellowship Training On Pathologic Outcomes and Complication Rates of Radical Prostatectomy." Cancer, vol. 107, no. 1, 2006, pp. 54-9.
Rosser CJ, Kamat AM, Pendleton J, et al. Impact of fellowship training on pathologic outcomes and complication rates of radical prostatectomy. Cancer. 2006;107(1):54-9.
Rosser, C. J., Kamat, A. M., Pendleton, J., Robinson, T. L., Pisters, L. L., Swanson, D. A., & Babaian, R. J. (2006). Impact of fellowship training on pathologic outcomes and complication rates of radical prostatectomy. Cancer, 107(1), 54-9.
Rosser CJ, et al. Impact of Fellowship Training On Pathologic Outcomes and Complication Rates of Radical Prostatectomy. Cancer. 2006 Jul 1;107(1):54-9. PubMed PMID: 16708356.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Impact of fellowship training on pathologic outcomes and complication rates of radical prostatectomy. AU - Rosser,Charles J, AU - Kamat,Ashish M, AU - Pendleton,John, AU - Robinson,Tracy L, AU - Pisters,Louis L, AU - Swanson,David A, AU - Babaian,Richard J, PY - 2006/5/19/pubmed PY - 2006/8/17/medline PY - 2006/5/19/entrez SP - 54 EP - 9 JF - Cancer JO - Cancer VL - 107 IS - 1 N2 - BACKGROUND: The study was conducted to assess the results of radical prostatectomy (RP) performed by fellowship-trained surgeons in the first year of independent practice. METHODS: A prospective cohort study of 66 men who underwent RP performed by 2 recently graduated fellowship-trained surgeons (C.J.R., n = 27; A.M.K., n = 39) in their first year of independent practice was undertaken. Preoperative, operative, and postoperative data were collected and analyzed. Median follow-up of the cohort is 12.5 months. RESULTS: The median patient age was 61.2 +/- 6.9 years (range, 44-74 years), the median prostate-specific antigen level was 5 ng/mL (range, 1.2-39.4 ng/mL), and the median prostate biopsy-determined Gleason score was 7. Of the 66 men, 25 (38%) underwent a bilateral nerve-sparing RP, 20 (30%) underwent a unilateral nerve-sparing RP, and 21 (32%) underwent a nonnerve-sparing procedure. Forty-two men (63%) underwent a pelvic lymph node dissection. The median operative time was 201 minutes. Median estimated blood loss was 734 mL (range, 300-1600 mL). There were 4 major complications--a pulmonary embolism in 3 patients and an intraoperative rectal injury in 1. Pathologic classification was as follows: pT2, 74%; pT3a, 23%; pT3b, 2%; and pN+, 2%. The positive margin rate was 14% overall and only 2% in men with pT2 disease. CONCLUSIONS: Results of RP performed by fellowship-trained surgeons in their first year of practice compare favorably with results of RP in a large series reported by more experienced surgeons. Being trained in an environment where an experienced surgeon serves as first assistant to the trainee appears to abbreviate the learning curve associated with this procedure. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/16708356/Impact_of_fellowship_training_on_pathologic_outcomes_and_complication_rates_of_radical_prostatectomy_ L2 - https://doi.org/10.1002/cncr.21955 DB - PRIME DP - Unbound Medicine ER -