The Surgical Learning Curve for Prostate Cancer Control After Radical Prostatectomy

This chapter summarizes an important study exploring the learning curve of surgeons performing open radical prostatectomy with clinically localized prostate cancer. The study retrospectively analyzed a large cohort of patients from several major medical centers who underwent surgery by several dozen surgeons with varying experience with regards to the outcome of freedom from biochemical recurrence. The study found a dramatic improvement in cancer control with increasing surgeon experience up to 250 prior operations but no large change with further surgeon experience. This study stands out as the first large, high-quality study in the urological literature to provide a detailed analysis of the association of surgical experience with an important clinical outcome measure. It provided compelling evidence that surgical experience with prostatectomy results in improved oncological outcomes.