Records from 64,900 radical prostatectomy (RP) patients treated between 2003 and 2007 were assessed. PLND rates were stratified according to RP technique: open RP (ORP) vs. MIRP. Multivariable logistic regression analyses (MVA) tested the independent predictor status of RP technique as determinants of PLND. Covariates consisted of age, race, comorbidity, year of surgery, and annual hospital volume.
Average patient age was 61.0 years and PLND was performed in 56% of patients. MIRP was performed in 6.3% of patients, while ORP accounted for the remaining 93.7%. The rate of PLND was statistically significantly lower in patients treated with MIRP vs. ORP (30.3 vs. 57.8%, p<0.001). In MVA, patients treated with MIRP had a 64.2% lower probability of PLND in comparison to those treated with ORP (p<0.001). The authors conclude that this variation represents an important quality of care concern.
Presented by Firas Abdollah, MD at the 26th Annual European Association of Urology (EAU) Congress - March 18 - 21, 2011 - Austria Centre Vienna, Vienna, Austria