Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/20779
Title: Declining use of radical prostatectomy and pelvic lymphadenectomy despite more robotics: National population data over 15 years.
Authors: Roberts, Matthew J;Papa, Nathan P;Perera, Marlon;Joshi, Andre;Scott, Susan;Bolton, Damien M;Lawrentschuk, Nathan;Yaxley, John
Affiliation: Faculty of Medicine, The University of Queensland, Brisbane, Australia
Department of Surgical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia
Department of Urology, Princess Alexandra Hospital, Brisbane, Australia
University of Melbourne, Department of Surgery, Austin Health, Melbourne, Australia
Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
Department of Urology, Royal Brisbane and Women's Hospital, Brisbane, Australia
Faculty of Medicine, The University of Queensland, Brisbane, Australia
Department of Surgery, Austin Health, The University of Melbourne, Heidelberg, Victoria, Australia
Department of Urology, Princess Alexandra Hospital, Brisbane, Australia
Faculty of Medicine, The University of Queensland, Brisbane, Australia
EJ Whitten Prostate Cancer Research Centre at Epworth Healthcare, Melbourne, Australia..
Issue Date: 6-May-2019
EDate: 2019-05-06
Citation: Asia-Pacific journal of clinical oncology 2019; online first: 6 May
Abstract: To describe national surgical patterns of prostate cancer (PCa) care considering radical prostatectomy with or without pelvic lymphadenectomy and consideration of robotic-assisted techniques. Retrospective analysis of publicly accessible Medicare claims data was performed for the period 2001-2016 and included patients undergoing radical prostatectomy with or without pelvic lymphadenectomy relative to total and PCa-specific populations among men aged 45-84 years. Proportion of cases performed robotically was considered. Total procedures performed increased from 2001, peaked in 2009 and subsequently decreased until 2016. Since 2009, the age-specific rate of surgery in men aged 75-84 increased by 2.3-fold, whereas the rates for men aged 55-64 and 45-54 reduced by 44% and 55%, respectively. Rates of concurrent pelvic lymphadenectomy fell until 2009 with subsequent stabilization (ratio 1.05-1.14) through to 2016. Significant regional practice patterns were observed, as was an increasing trend toward a robotic-assisted laparoscopic approach, comprising more than 80% of radical prostatectomies in 2016. Since the peak in 2009, radical prostatectomy is performed less in men <65 years and more in men ≥65 years. An increasing proportion of cases omit concurrent pelvic lymphadenectomy and are performed robotically.
URI: http://ahro.austin.org.au/austinjspui/handle/1/20779
DOI: 10.1111/ajco.13158
ORCID: 0000-0003-0552-7402
0000-0002-3188-1803
0000-0002-5145-6783
0000-0002-1138-6389
0000-0001-8553-5618
PubMed URL: 31056859
Type: Journal Article
Subjects: pelvic lymphadenectomy
prostate cancer
radical prostatectomy
treatments
trends
Appears in Collections:Journal articles

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