Laparoscopic radical prostatectomy’s learning curve slow.
Medscape (4/2, Nelson) reported, “After a radical prostatectomy, the risk for recurrence is strongly affected by the experience of the operating surgeon,” an actuality that holds “true for both open and laparoscopic procedures.” But, investigators at the Memorial Sloan-Kettering Cancer Center, also pointed out that the “learning curve for surgery — improvement in surgical outcomes with increasing surgeon experience — appears to accrue more slowly for laparoscopic radical prostatectomy than for open surgery.” Lead researcher Andrew Vickers, PhD, explained, “If they are only doing a handful of radical prostatectomies a year, then [surgeons] are going to have a hard time getting up on the learning curve. A great deal of surgical experience is required to treat prostate cancer optimally.”
The team reached such conclusions after reviewing the “records of 4,702 prostate cancer patients treated laparoscopically by one of 29 surgeons from seven institutions in Europe and North America between 1998 and 2007,” according to Medwire (4/2, Davenport). “In all, 41 percent of surgeons had performed less than 50 laparoscopic procedures, while seven percent had performed 50-99 procedures, 34 percent had performed 100-249 procedures, and 17 percent had performed 750 or more procedures. In addition, 45 percent of surgeons had performed no open procedures before their first laparoscopic procedures…. Compared with the previous findings for open surgery, the learning curve for laparoscopic surgery was significantly slower.”