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42. Gemeinsame Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie

02. - 04.06.2016, Augsburg

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Prognostic value of surgeons experience in patients undergoing radical cystectomy for urothelial carcinoma: results of a single center study

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  • T. Grimm - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Buchner - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • B.-S. Schneevoigt - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Kretschmer - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • M. Apfelbeck - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • M.T. Grabbert - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • F. Jokisch - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • G. Schulz - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • C.G. Stief - Ludwig-Maximilians-Universität München, Urologie, München, Germany
  • A. Karl - Ludwig-Maximilians-Universität München, Urologie, München, Germany

Bayerische Urologenvereinigung. Österreichische Gesellschaft für Urologie und Andrologie. 42. Gemeinsame Tagung der Bayerischen Urologenvereinigung und der Österreichischen Gesellschaft für Urologie und Andrologie. Augsburg, 02.-04.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocKV14

doi: 10.3205/16urobay014, urn:nbn:de:0183-16urobay0149

Published: April 20, 2016

© 2016 Grimm et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.

Outline

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Introduction and objectives: Performing a radical cystectomy (RC) is a challenging procedure with a long learning curve. There is only limited knowledge about the prognostic relevance of a surgeon's individual level of skill in practicing RC for urothelial carcinoma (UC). In this study we analyzed the impact of surgeons experience on cancer-specific survival (CSS) in UC patients with RC.

Materials and methods: Data about 22 different surgeons performing a total of 818 RC due to UC from 2004 to 2015 at our institution were available. Surgeon's experience was defined by the number of RC performed, with cut-off levels at up to 50; 51-200, and more than 200 (17; 4 and 1 surgeons, respectively). Median follow up time was 25 months (range 1 - 135 months). CSS was analyzed using Kaplan-Meier method and Cox regression models.

Results: In our univariate analysis surgeon's volume of performed RC had significant impact on CSS. With higher total volumes of performed RC, better oncologic outcome in our patients was observed (five year cancer-specific survival 52% vs. 61% vs. 64%, respectively; p< 0.010).

In our multivariate analysis these findings could not reach statistically significance. However a higher surgeons experience showed a strong tendency towards better oncologic outcome in our patients (p=0.051).

Conclusion: In our large single center study surgeons experience was predictive for oncologic outcome in UC patients with RC. These findings assume that RC performed in high volume centers and the establishment of training programs may improve results.