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Updated: Jun 19, 2026
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Low annual caseloads of United States surgeons conducting radical prostatectomy
Caroline J Savage1, Andrew J Vickers
1Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Purpose:
It has been clearly demonstrated that surgeons with increased yearly caseloads have lower complication rates. Moreover it has been shown that a surgeon needs to conduct at least 250 radical prostatectomies to maximize cancer control (the surgical learning curve).
Materials And Methods:
To determine typical annual radical prostatectomy caseloads of surgeons in the United States we analyzed data from 2 independent data sets for 2005, that of a nationally representative sample (Nationwide Inpatient Sample) and a complete record of all hospital discharges from New York State (Statewide Planning and Research Cooperative System).
Results:
More than 25% of United States surgeons conducting radical prostatectomy in 2005 performed only a single procedure. Approximately 80% of surgeons performed fewer than 10 procedures per year and, thus, are unlikely to reach the plateau of the learning curve during their surgical career.
Conclusions:
The current pattern of surgical treatment for prostate cancer leads to many patients being treated by surgeons with low annual caseloads, with likely poorer outcomes as a result.
