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Are you now a good surgeon? T2 positive margin status as a quality outcome measure following radical prostatectomy

Damani, A; Van Hemelrijck, M; Wulaningsih, W; Crawley, D; Cahill, D; (2017) Are you now a good surgeon? T2 positive margin status as a quality outcome measure following radical prostatectomy. World Journal of Urology , 35 (1) pp. 35-43. 10.1007/s00345-016-1836-0. Green open access

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Abstract

OBJECTIVE: To assess potential biases, such as the reporting pathologist, that may affect objectivity of T2 positive margin rates as a quality outcome measure following radical prostatectomy. PATIENTS AND METHODS: Prospective data on 183 consecutive LRP patients with pT2 disease, operated on by a single surgeon (2003-2009), were studied. Outcomes were grouped as pre-, peri-, and post-operative and included: age, ethnicity, Gleason score, reporting pathologist, percentage of positive cores, operative time, blood loss, nerve-sparing status, hospital stay and prostate weight. Descriptive analysis and logistic regression analysis were carried out to compare these variables by positive margin status. RESULTS: A total of 30 (16.4 %) positive surgical margins (PSMs) were reported. Surgical stage, earlier date of surgery, and lower prostatic weight showed statistically significant associations with PSM status in both univariate and multivariate analysis. The reporting pathologist was not found to be predictive of PSMs (P = 0.855). CONCLUSION: We showed that the reporting pathologist does not influence T2 positive margin status, in contrast to tumour characteristics and surgeon experience. T2 positive margin assessment therefore appears to be an objective quality outcome measure.

Type: Article
Title: Are you now a good surgeon? T2 positive margin status as a quality outcome measure following radical prostatectomy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1007/s00345-016-1836-0
Publisher version: http://doi.org/10.1007/s00345-016-1836-0
Language: English
Additional information: © The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
Keywords: Laparoscopic surgery, Outcomes assessment, Positive margins, Prostate cancer, Radical prostatectomy
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
URI: https://discovery.ucl.ac.uk/id/eprint/1504366
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