Ashish M. Kamat: Impact of fellowship training on outcomes and complication rates of radical prostatectomy
Ashish M. Kamat, Endowed Professor of Urologic Oncology (Surgery) and Cancer Research at University of Texas MD Anderson Cancer Center, shared his recent article on X:
Impact of fellowship training on pathologic outcomes and complication rates of radical prostatectomy
Authors: Charles J. Rosser, et al.
Summary of the Study:
Objective:
Assess outcomes of radical prostatectomy (RP) performed by fellowship-trained surgeons in their first year of independent practice.
Study Design:
Prospective cohort study involving 66 men with localized prostate cancer.
Conducted by two recently graduated fellowship-trained surgeons (C.J.R. and A.M.K.) from September 2003 to August 2004.
Median follow-up period: 12.5 months.
Patient Demographics:
Median age: 61.2 years (range: 44–74 years).
Median prostate-specific antigen (PSA) level: 5 ng/mL (range: 1.2–39.4 ng/mL).
Median Gleason score: 7.
Surgical Approaches:
Bilateral nerve-sparing RP: 38% of patients.
Unilateral nerve-sparing RP: 30% of patients.
Non-nerve-sparing procedures: 32% of patients.
Pelvic lymph node dissection performed in 63% of cases.
Operative Metrics:
Median operative time: 201 minutes.
Median estimated blood loss: 734 mL (range: 300–1600 mL).
Complications:
Major complications included:
Three cases of pulmonary embolism.
One intraoperative rectal injury.
Pathological Outcomes:
Pathological classifications:
- pT2 (organ-confined): 74%.
- pT3a: 23%.
- pT3b (seminal vesicle invasion): 2%.
Positive margin rate: Overall 14%; only 2% in pT2 patients.
Conclusions:
Outcomes of RP by fellowship-trained surgeons are comparable to those achieved by more experienced surgeons.
Structured training in a supportive environment may reduce the learning curve for complex procedures like RP.
Significance:
Highlights the importance of fellowship training in improving surgical proficiency and patient outcomes in urologic oncology.
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