Utilization and Outcomes for Minimally Invasive Prostate Cancer Treatment
Leads to Lower Surgical Complication Rates Though Long-Term Outcomes Dependant on Surgeon Experience
Boston, MA – Many patients perceive minimally invasive surgery as the better choice over open surgical procedures; however, up to this point, little data was available about utilization and outcomes of minimally invasive radial prostatectomy (MIRP) to treat prostate cancer compared with the older open radical prostatectomy approach.
Jim Hu, MD, MPH, and colleagues at Brigham and Women’s Hospital (BWH) assessed surgical utilization and complications, lengths of hospital stay and cancer outcomes in over 2,700 men who underwent prostate cancer surgery and found that MIRP usage almost tripled between 2003 and 2005 – a striking finding since the procedure was introduced in the US in 2000. Additionally, the researcher found although MIRP patients had less surgical complications and shorter hospital stays by almost three days, they were more likely to require additional cancer treatments after surgery compared to men undergoing open surgery. These findings appear in the May 10, 2008, issue of the Journal of Clinical Oncology.
“In short time, MIRP has taken over as one of the most popular treatments for prostate cancer, but one cannot help but think this procedure was adopted by surgeons too quickly because cancer outcomes for MIRP patients overall were not as favorable as those who underwent open radical prostatectomy,” said lead author Hu. “However, the results of our national study differ from outcomes at high volume centers where cancer control for the open and minimally invasive approaches are very similar.”
The researchers found that experienced or high volume MIRP surgeons were more likely to have favorable cancer outcomes compared to low-volume MIRP surgeons, suggesting that the rapid adoption of the procedure by eager surgeons, not the procedure itself, is a possible cause for worse long-term outcomes compared with open radical prostatectomy.
“There is a steep learning curve for MIRP and based on our research, I would tell patients deciding on a prostate cancer treatment to pay attention to the experience of their doctor and not be seduced by the smaller incisions and newer technologies offered by minimally invasive surgery,” Hu added.
This research was supported by a Lance Armstrong Young Investigator Award, a Dana-Farber/Harvard Cancer Center Career Development Award and by a grant from the Brigham and Women’s Center for Surgery and Public Health.
For more information, contact BWH Media Relations at (617) 534-1600 or bwhmediarelations@partners.org.
Brigham and Women's Hospital is a 747-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare, an integrated health care delivery network. BWH is committed to excellence in patient care with expertise in virtually every specialty of medicine and surgery. BWH is an international leader in basic, clinical and translational research on human diseases, involving more than 860 physician-investigators and renowned biomedical scientists and faculty supported by more than $416 M in funding. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative.
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