OBJECTIVE: Population-based data on radical prostatectomy (RP) adoption and outcomes are available mainly from Northern America and Northern Europe.
To estimate time trends in the recourse to RP and in short-term outcomes after RP in Italy.
PATIENTS AND METHODS: All RP for prostate cancer performed in 2001-2010 were extracted from the Italian national archive of hospital discharge records. Age-specific and age-standardized RP rates were computed. The effect of procedural volume on in-hospital mortality, complications, and length of stay was estimated by multilevel regression models.
RESULTS: 144,432 RP were analyzed. Country-wide RP rates increased in 2001-2004 and thereafter remained stable, with large differences between geographical areas. The mean hospital volume raised in the first study years, without centralization but due to increasing RP numbers at the population level. The median LOS declined from 10 to 8 days over the study period (mean from 11.7 to 9.2 days). In-hospital mortality dropped from 0.16% in 2001 to 0.07% in 2010. In-hospital mortality, LOS, and the prevalence of complications increased with age, and decreased with year of surgery. Compared to very low-volume hospitals, procedures performed in high volume hospitals were associated to decreased in-hospital mortality, in-hospital complications, and hospital stay.
CONCLUSIONS: The study adds evidence on rapidly changing trends in RP rates, on improving in-hospital outcomes, and on their association with procedural volume.
Novara G, Ficarra V, Zattoni F, Fedeli U. Are you the author?
Department of Surgery, Oncology, and Gastroenterology - Urology Clinic, University of Padova, Italy.
Reference: BJU Int. 2014 Nov 28. Epub ahead of print.