Adult UrologiesThirty-day mortality rates and cumulative survival after radical retropubic prostatectomy☆
Section snippets
Material and methods
The Quebec Healthcare Plan is the exclusive insurance plan in the Province of Quebec. As such, all RRP reimbursements, identified by its specific billing code, can be traced in the Healthcare Plan Database. Relying on the Plan Database, we obtained an anonymously coded list of all RRPs performed in the Province of Quebec between January 5, 1988 and January 16, 1996. All procedures were accompanied by their respective date and the type of hospital where they were performed. The hospitals
Results
According to the Quebec Healthcare Plan Database, 4997 consecutive men underwent RRP during the period of this study (January 5, 1988 to January 16, 1996). Their age at the time of the RRP ranged from 31 to 83 years (mean 64, median 65). Table I contains further descriptive statistics pertaining to the study population and the annual RRP trends. Figure 1 demonstrates the number of RRPs performed by each of the 104 urologists during the study period. Overall, 451 deaths (9.0% overall death
Comment
Although this large-scale, population-based study was not designed to assess cancer-specific outcomes associated with RRP, it allows several important observations. Our results demonstrate a significant improvement in outcomes over time, as evidenced by decreasing 30-day mortality rates and improving overall survival. These findings confirm the initial hypothesis of improved patient selection and optimized intraoperative and postoperative care. Therefore, the practicing urologists and patients
Conclusions
In this large, population-based analysis of RRP outcomes, we demonstrated that current RRP outcomes translate into negligible (0.5%) 30-day mortality and excellent overall survival (98.1% at 31 months of follow-up). These trends substantially improved over the 8 years spanning the study and will probably continue to improve in the future. The recorded outcome trends may be accounted for by improved patient selection and care. Although we are unable to determine cancer-specific outcomes, the
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Cited by (0)
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This work was supported by a grant from Zeneca Pharmaceuticals.