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Scandinavian Journal of Urology Volume 56, 2022 - Issue 3
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Articles

Learning curve for robot-assisted laparoscopic radical prostatectomy in a large prospective multicentre study

David Bocka Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Scandinavian Surgical Outcomes Research Group, Gothenburg, SwedenCorrespondence[email protected]
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Martin Nybergb Department of Translational Medicine, Division of Urological Cancers, Faculty of Medicine, Lund University, Lund, Sweden;c Department of Urology, Skåne University Hospital, Malmö, SwedenView further author information
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Anna Lantzd Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, Sweden;e Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SwedenView further author information
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Sigrid V. Carlssonf Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USA;g Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, SwedenORCID Iconhttps://orcid.org/0000-0003-3553-5710View further author information
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Daniel D. Sjobergf Departments of Surgery (Urology Service) and Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USAView further author information
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Stefan Carlssond Department of Molecular Medicine and Surgery, Section of Urology, Karolinska Institute, Stockholm, SwedenView further author information
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Johan Stranneg Department of Urology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden;h Department of Urology Gothenburg, Region Västra Götaland, Sahlgrenska University Hospital, Goteborg, SwedenORCID Iconhttps://orcid.org/0000-0002-4295-6524View further author information
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Gunnar Steinecki Department of Oncology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, SwedenORCID Iconhttps://orcid.org/0000-0002-0787-3969View further author information
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Peter Wiklundj Department of Urology, Icahn School of Medicine at Mount Sinai Health System, New York, NY, USAView further author information
,
Eva Haglinda Department of Surgery, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Scandinavian Surgical Outcomes Research Group, Gothenburg, Sweden;k Department of Surgery, Region Västra Götaland, Sahlgrenska University Hospital/Östra, Gothenburg, SwedenView further author information
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Anders Bjartellb Department of Translational Medicine, Division of Urological Cancers, Faculty of Medicine, Lund University, Lund, Sweden;c Department of Urology, Skåne University Hospital, Malmö, SwedenORCID Iconhttps://orcid.org/0000-0002-5761-3786View further author information
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Pages 182-190 | Received 04 Mar 2022, Accepted 19 Apr 2022, Published online: 12 May 2022

Figures & data

Table 1. Definitions of study outcomes.

Figure 1. Patient flowchart. PSA = prostate-specific antigen.

Figure 1. Patient flowchart. PSA = prostate-specific antigen.

Figure 2. Left panel: percentage of patients with a negative surgical margin (no cancer cells in the surgical margin of specimens) as found in the pathology report. Right panel: predicted cumulative chance of freedom from biochemical recurrence 4 years after surgery. The unadjusted curve (blue dashed line) represents estimates from regression with no covariates included. The adjusted curve (red solid line) represents estimates from regression with covariates included. The grey area is the 95% confidence interval (CI) for adjusted estimates. Black dots depict raw proportions with 95% CI. The number of surgeons performing at least 1, 50, 200, 500 and 750 surgeries is given at the bottom of the left panel.

Figure 2. Left panel: percentage of patients with a negative surgical margin (no cancer cells in the surgical margin of specimens) as found in the pathology report. Right panel: predicted cumulative chance of freedom from biochemical recurrence 4 years after surgery. The unadjusted curve (blue dashed line) represents estimates from regression with no covariates included. The adjusted curve (red solid line) represents estimates from regression with covariates included. The grey area is the 95% confidence interval (CI) for adjusted estimates. Black dots depict raw proportions with 95% CI. The number of surgeons performing at least 1, 50, 200, 500 and 750 surgeries is given at the bottom of the left panel.

Figure 3. Percentage of patients reporting urinary continence (defined as change of sanitary pad less than once per 24 h) at 3, 12 and 24 months postoperatively. The unadjusted curve (blue dashed line) represents estimates from regression with no covariates included. The adjusted curve (red solid line) represents estimates from regression with covariates included. The grey area is the 95% confidence interval (CI) for adjusted estimates. Black dots depict raw proportions with 95% CI. The number of surgeons performing at least 1, 50, 200, 500 and 750 surgeries is given at the bottom of the left panel.

Figure 3. Percentage of patients reporting urinary continence (defined as change of sanitary pad less than once per 24 h) at 3, 12 and 24 months postoperatively. The unadjusted curve (blue dashed line) represents estimates from regression with no covariates included. The adjusted curve (red solid line) represents estimates from regression with covariates included. The grey area is the 95% confidence interval (CI) for adjusted estimates. Black dots depict raw proportions with 95% CI. The number of surgeons performing at least 1, 50, 200, 500 and 750 surgeries is given at the bottom of the left panel.

Figure 4. Percentage of patients reporting erectile function (defined as having a stiff enough penis for penetration after sexual stimulation at least 50% of times) at 3, 12 and 24 months postoperatively. The unadjusted curve (blue dashed line) represents estimates from regression with no covariates included. The adjusted curve (red solid line) represents estimates from regression with covariates included. The grey area is the 95% confidence interval (CI) for adjusted estimates. Black dots depict raw proportions with 95% CI. The number of surgeons performing at least 1, 50, 200, 500 and 750 surgeries is given at the bottom of the left panel.

Figure 4. Percentage of patients reporting erectile function (defined as having a stiff enough penis for penetration after sexual stimulation at least 50% of times) at 3, 12 and 24 months postoperatively. The unadjusted curve (blue dashed line) represents estimates from regression with no covariates included. The adjusted curve (red solid line) represents estimates from regression with covariates included. The grey area is the 95% confidence interval (CI) for adjusted estimates. Black dots depict raw proportions with 95% CI. The number of surgeons performing at least 1, 50, 200, 500 and 750 surgeries is given at the bottom of the left panel.

Table 2. Patient, tumour and surgeon characteristics.

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