Association between surgeon and hospital characteristics and lymph node counts from radical prostatectomy and pelvic lymph node dissection

Elyn H. Wang, James B. Yu, Cary P. Gross, Robert Abouassaly, Edward E. Cherullo, Marc C. Smaldone, Nilay D Shah, Jonathon Kiechle, Quoc Dien Trinh, Maxine Sun, Simon P. Kim

Research output: Contribution to journalArticle

8 Citations (Scopus)

Abstract

OBJECTIVE: To assess whether surgical approach and hospital characteristics independently determine the number of lymph nodes (LNs) removed from prostate cancer patients undergoing radical prostatectomy (RP) and pelvic LN dissection (PLND).

METHODS: Using the National Cancer Database, we identified all surgically treated patients diagnosed with pretreatment intermediate- or high-risk prostate cancer from 2010 to 2011. The primary outcome was the number of LNs retrieved at the time of RP. Generalized estimating equations were used to assess for differences in the adjusted number of LNs retrieved after accounting for patient and hospital characteristics and surgical approach.

RESULTS: Overall, 35,876 patients were diagnosed with intermediate-risk (61.2%) and high-risk (38.8%) prostate cancer and underwent RP and PLND.On multivariate analysis, open RP and high-volume and academic hospitals were independently associated with greater LN counts compared with robotic-assisted RP and medium or low and community hospitals, respectively (all P <.001). After adjusting for patient and hospital variables, higher adjusted LN counts were observed for open RP compared with robotic-assisted RP (7.1 vs 6.1; P <.001). Adjusted counts were also higher for high-volume hospitals compared with medium- or low-volume hospitals (7.8 vs 5.9; P <.001), and academic compared with community hospitals (7.3 vs 5.6; P <.001).

CONCLUSION: Among patients with aggressive prostate cancer treated with RP and PLND, retrieval of LN counts varied by surgical approach and hospital characteristics.

Original languageEnglish (US)
Pages (from-to)890-895
Number of pages6
JournalUrology
Volume85
Issue number4
DOIs
StatePublished - Apr 1 2015

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Prostatectomy
Lymph Node Excision
Lymph Nodes
Prostatic Neoplasms
High-Volume Hospitals
Community Hospital
Robotics
Low-Volume Hospitals
Surgeons
Dissection
Multivariate Analysis
Databases
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Wang, E. H., Yu, J. B., Gross, C. P., Abouassaly, R., Cherullo, E. E., Smaldone, M. C., ... Kim, S. P. (2015). Association between surgeon and hospital characteristics and lymph node counts from radical prostatectomy and pelvic lymph node dissection. Urology, 85(4), 890-895. https://doi.org/10.1016/j.urology.2015.01.006

Association between surgeon and hospital characteristics and lymph node counts from radical prostatectomy and pelvic lymph node dissection. / Wang, Elyn H.; Yu, James B.; Gross, Cary P.; Abouassaly, Robert; Cherullo, Edward E.; Smaldone, Marc C.; Shah, Nilay D; Kiechle, Jonathon; Trinh, Quoc Dien; Sun, Maxine; Kim, Simon P.

In: Urology, Vol. 85, No. 4, 01.04.2015, p. 890-895.

Research output: Contribution to journalArticle

Wang, EH, Yu, JB, Gross, CP, Abouassaly, R, Cherullo, EE, Smaldone, MC, Shah, ND, Kiechle, J, Trinh, QD, Sun, M & Kim, SP 2015, 'Association between surgeon and hospital characteristics and lymph node counts from radical prostatectomy and pelvic lymph node dissection', Urology, vol. 85, no. 4, pp. 890-895. https://doi.org/10.1016/j.urology.2015.01.006
Wang, Elyn H. ; Yu, James B. ; Gross, Cary P. ; Abouassaly, Robert ; Cherullo, Edward E. ; Smaldone, Marc C. ; Shah, Nilay D ; Kiechle, Jonathon ; Trinh, Quoc Dien ; Sun, Maxine ; Kim, Simon P. / Association between surgeon and hospital characteristics and lymph node counts from radical prostatectomy and pelvic lymph node dissection. In: Urology. 2015 ; Vol. 85, No. 4. pp. 890-895.
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AU - Smaldone, Marc C.

AU - Shah, Nilay D

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