Austin Health

Title
Declining use of radical prostatectomy and pelvic lymphadenectomy despite more robotics: National population data over 15 years.
Publication Date
2020-04
Author(s)
Roberts, Matthew J
Papa, Nathan P
Perera, Marlon
Joshi, Andre
Scott, Susan
Bolton, Damien M
Lawrentschuk, Nathan
Yaxley, John
Subject
pelvic lymphadenectomy
Prostate cancer
radical prostatectomy
treatments
trends
Type of document
Journal Article
OrcId
0000-0003-0552-7402
0000-0002-3188-1803
0000-0002-5145-6783
0000-0002-1138-6389
0000-0001-8553-5618
DOI
10.1111/ajco.13158
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.
Link
Citation
Asia-Pacific journal of clinical oncology 2020; 16(2): e118-e124
Jornal Title
Asia-Pacific journal of clinical oncology

Files:

NameSizeformatDescriptionLink