European Urology Open Science (Dec 2021)

A 5-Year Contemporary Nationwide Evolution of the Radical Prostatectomy Landscape

  • Guillaume Ploussard,
  • Annabelle Grabia,
  • Jean-Baptiste Beauval,
  • Eric Barret,
  • Laurent Brureau,
  • Charles Dariane,
  • Gaëlle Fiard,
  • Gaëlle Fromont,
  • Mathieu Gauthé,
  • Romain Mathieu,
  • Raphaële Renard-Penna,
  • Guilhem Roubaud,
  • Alain Ruffion,
  • Paul Sargos,
  • François Rozet,
  • Charles-Edouard Lequeu,
  • Morgan Rouprêt

Journal volume & issue
Vol. 34
pp. 1 – 4

Abstract

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The evolution in the past decade of recommendations for prostate cancer (PCa) management, from screening to surgical treatment, may have affected the radical prostatectomy (RP) landscape. However, comprehensive data at a national level remain scarce. We extracted 5-yr data for RP patients in France from the central database of the national health care system. The primary endpoints were surgical approach (open [ORP], laparoscopic [LRP], and robot-assisted RP [RARP]), length of stay (LOS), and complication and readmission rates. The annual number of RPs was stable during the study period. The proportion of RARPs increased from 39.8% in 2015 to 52.6% in 2019, whereas the proportion of ORPs decreased from 34.4% to 24.5%. LOS continuously decreased over time irrespective of the surgical approach. The proportion of centres in the highest quartile of hospital volume increased from 22.0% to 28.3% (p = 0.006). LOS and complication and readmission rates were significantly lower (p < 0.001) in the LRP cohort at each time point. National trends confirmed that RARP progressively replaced ORP, with a stable number of annual RPs over time. Greater centralisation and better early postoperative outcomes were observed with laparoscopy. Patient summary: We reviewed French data for patients undergoing removal of the prostate for prostate cancer between 2015 and 2019. We found that robot-assisted minimally invasive surgery has increased over time and the length of hospital stays has decreased. Rates of complications and readmission were lower with minimally invasive surgery.

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