Association of hospital volume with perioperative and oncological outcomes of robot-assisted laparoscopic radical prostatectomy: a retrospective multicenter cohort study
Tomoyuki Tatenuma,
Shin Ebara,
Makoto Kawase,
Takeshi Sasaki,
Yoshinori Ikehata,
Akinori Nakayama,
Masahiro Toide,
Tatsuaki Yoneda,
Kazushige Sakaguchi,
Jun Teishima,
Takahiro Inoue,
Hiroshi Kitamura,
Kazutaka Saito,
Fumitaka Koga,
Shinji Urakami,
Takuya Koie,
Kazuhide Makiyama
Affiliations
Tomoyuki Tatenuma
Department of Urology, Yokohama City University Hospital
Shin Ebara
Department of Urology, Hiroshima City Hiroshima Citizens Hospital
Makoto Kawase
Department of Urology, Gifu University Graduate School of Medicine
Takeshi Sasaki
Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine
Yoshinori Ikehata
Department of Urology, University of Toyama
Akinori Nakayama
Department of Urology, Dokkyo Medical University Saitama Medical Center
Masahiro Toide
Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Tatsuaki Yoneda
Department of Urology, Seirei Hamamatsu General Hospital
Kazushige Sakaguchi
Department of Urology, Toranomon Hospital
Jun Teishima
Department of Urology, Graduate School of Biomedical and Health Science, Hiroshima University
Takahiro Inoue
Department of Nephro-Urologic Surgery and Andrology, Mie University Graduate School of Medicine
Hiroshi Kitamura
Department of Urology, University of Toyama
Kazutaka Saito
Department of Urology, Dokkyo Medical University Saitama Medical Center
Fumitaka Koga
Department of Urology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital
Shinji Urakami
Department of Urology, Toranomon Hospital
Takuya Koie
Department of Urology, Gifu University Graduate School of Medicine
Kazuhide Makiyama
Department of Urology, Yokohama City University Hospital
Abstract Background This retrospective multicenter cohort study investigated the association of hospital volume with perioperative and oncological outcomes in patients treated with robot-assisted radical prostatectomy (RARP). Methods We collected the clinical data of patients who underwent RARP at eight institutions in Japan between September 2012 and August 2021. The patients were divided into two groups based on the treatment site—high- and non-high-volume hospitals. We defined a high-volume hospital as one where RARP was performed for more than 100 cases per year. Results After excluding patients who received neoadjuvant therapy, a total of 2753 patients were included in this study. In the high-volume hospital group, console time and estimated blood loss were significantly (p < 0.001) lower than that of the non-high-volume hospital group. However, the continence rate at 3 months after RARP, positive surgical margins, and prostate-specific antigen (PSA)-relapse-free survival showed no significant differences between the two groups. Furthermore, the console time was significantly shorter after 100 cases in the non-high-volume hospital group but not in the high-volume hospital group. Conclusions A higher hospital volume was significantly associated with shorter console time and less estimated blood loss. However, oncological outcomes and early continence recovery appear to be comparable regardless of the hospital volume in Japan.
