Evaluating trends in radical prostatectomy approach and 30-day complication rate in Ontario from 2010–2019

Authors

  • Nickan Motamedi London Health Sciences Centre
  • Andrew McClure London Health Sciences Centre
  • Nicholas Power London Health Sciences Centre
  • Stephen Pautler London Health Sciences Centre
  • Lilian Gien Sunnybrook Health Sciences Centre
  • Blayne Welk London Health Sciences Centre
  • Jacob McGee London Health Sciences Centre

DOI:

https://doi.org/10.5489/cuaj.8636

Keywords:

Radical Prostatectomy, Robotic, robot-assisted radical prostatectomy, complication rate, Surgeon volume

Abstract

INTRODUCTION: Radical prostatectomy (RP) for prostate cancer has changed over the years with the advent of minimally invasive (MIRP) approaches, which includes robotic-assisted RP (RARP). The MIRP approaches have been shown to reduce complication rate, but there remain barriers to adoption. The objective of this study was to quantitatively describe the trend in the RP approach in Ontario, and to assess the trend in complication rates.

METHODS: We conducted a population-based, retrospective cohort study including all men who underwent RP for prostate cancer in Ontario from 2010–2019. We used administrative data from Ontario’s health databases to gather surgical outcome data. Our primary outcomes were the annualized frequency of RP by surgical approach and annualized 30-day composite complication rate.

RESULTS: In total, 22 118 patients were included in the analysis over the study period. There was a trend away from retropubic (RRP) frequency over the study period (80.3% of cases in fiscal year [FY] 2010 to 55.6% in FY 2018) and towards RARP approach (6.8% of cases in FY 2010 and 36.7% in FY 2018). The most common complication was blood transfusion at 6.26%, which saw a downtrend over the study period (7.96% FY 2010, 3.47% FY 2018). The odds ratio for 30-day complication for open RP compared to MIRP was 1.74 (95% confidence interval 1.57–1.92, p<0.001).

CONCLUSIONS: In Ontario, there has been a steady shift away from RRP and towards RARP. Minimally invasive approaches portend a significantly lower complication rate, likely driven by a lower blood transfusion rate.

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Published

2024-10-07

How to Cite

Motamedi, N., McClure , A. ., Power, N., Pautler, S., Gien, L., Welk, B., & McGee, J. (2024). Evaluating trends in radical prostatectomy approach and 30-day complication rate in Ontario from 2010–2019. Canadian Urological Association Journal, 19(2), 42–8. https://doi.org/10.5489/cuaj.8636

Issue

Vol. 19 No. 2 (2025): CUAJ February

Section

Original Research

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