Radical prostatectomy QoL outcomes can be obtained in single-surgeon practices

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Mar 30 2006

Most often urologists cite radical prostatectomy (RP) outcomes from large studies and high volume centers. However, these may not accurately reflect the outcomes of individual surgeons.

Patients increasingly ask for individual surgeon outcomes as they comparatively "shop" for a surgeon. The ability to create and maintain an outcomes database is perceived as expensive and time-consuming.

Dr. Dalkin from Tucson, AZ reports his 6-year outcomes in the January/February issue of Urologic Oncology. Between 1999 and 2005 consecutive men undergoing RP were given the SF-36 and UCLA-PCI QoL surveys pre-operatively. Patients remained unidentified and after completion at home, they returned the surveys in pre-addressed, stamped envelopes to a third party data collection center unaffiliated with Dr. Dalkin. Those men returning the surveys were then mailed follow-up surveys at years 1 and 2 post-operatively. A statistical package was used for data analysis.

The study demonstrated that men are willing to respond, with 90% and 82% of patients captured at 1 and 2 years, respectively. At 2 years post-op, 105 men had complete data. Pad-free rates were 82% at 1 year and 89% at 2 years. In men under age 60 years with unilateral nerve-sparing. 50% reported erections adequate for intercourse at 24 months post-op. Bilateral nerve-sparing was not routinely performed by Dr. Dalkin, due to his concern regarding cancer risk. However, no oncologic outcomes were captured as part of this database.

At the least this report suggests that with moderate resources and time investment, QoL outcomes can be obtained by urologists for procedures that they deem important for their patients. A full database with oncologic outcomes would require more data entry and associated costs.

By Christopher P. Evans, MD

Reference:

Urol Oncol 2006; 24:28-32