Changing face of robot‐assisted radical prostatectomy in Melbourne over 12 years

Background This study aims to characterize the trends in disease presentation for robot‐assisted radical prostatectomy (RARP) over a 12‐year period in Melbourne, Australia. Methods All patients undergoing an RARP between 2004 and October 2016 while under the care of six high‐volume surgeons were inc...

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Bibliographic Details
Published in:ANZ journal of surgery Vol. 88; no. 3; pp. E200 - E203
Main Authors: Sathianathen, Niranjan J., Lamb, Alastair D., Lawrentschuk, Nathan L., Goad, Jeremy R., Peters, Justin, Costello, Anthony J., Murphy, Declan G., Moon, Daniel A.
Format: Journal Article
Language:English
Published: Melbourne John Wiley & Sons Australia, Ltd 01.03.2018
Blackwell Publishing Ltd
Subjects:
Age
Age Factors
Aged
Australia
Biopsy
Cancer
Cancer surgery
Demographics
Demography
Health risks
Humans
laparoscopic surgery
Male
Medical personnel
Men
Middle Aged
Neoplasm Grading
Neoplasm Staging
Patient Selection
Patients
Prostate cancer
Prostatectomy
Prostatectomy - statistics & numerical data
Prostatic Neoplasms - pathology
Prostatic Neoplasms - surgery
Quality
Risk
Risk groups
Robotic surgery
robotic surgical procedure
Robotic Surgical Procedures - statistics & numerical data
Trends
Tumors
Urological surgery
Australia
Melbourne Victoria Australia
prostatectomy
prostate cancer
robotic surgical procedure
laparoscopic surgery
ISSN:1445-1433, 1445-2197, 1445-2197
Online Access:Get full text
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Summary:Background This study aims to characterize the trends in disease presentation for robot‐assisted radical prostatectomy (RARP) over a 12‐year period in Melbourne, Australia. Methods All patients undergoing an RARP between 2004 and October 2016 while under the care of six high‐volume surgeons were included in this study. Data were collected prospectively regarding patient demographics and clinical details of their cancer. Results Over the 12‐year time span of the study, 3075 men underwent an RARP with a median age of 63.01 years. Temporal analysis demonstrated that the median age of patients undergoing prostatectomy advanced with time with the median age in 2016 being 65.51 years compared with 61.0 years in 2004 (P < 0.001). There was also a significant trend to increased D'Amico risk groups over time with the percentage procedures for high‐risk patients increasing from 12.6% to 28.10% from 2004 to 2016 (P < 0.001). Upgrade rates between biopsy and pathological Gleason grade scoring significantly trended down over the period of the study (P < 0.001). There was also a shift to increased pathological stage over the 12 years with 22.1% of men having T3 disease in 2004 compared with 49.8% in 2016. Conclusion Our analysis demonstrates increasing treatment of older men with higher risk tumours, consistent with international trends. While this largely reflects a shift in case selection, further work is needed to assess whether the stage shift may relate partially to a decline in screening and increased presentation of higher risk disease.
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ISSN:1445-1433
1445-2197
1445-2197
DOI:10.1111/ans.14169