Related Experiment Video
Updated: Feb 25, 2026
12:10
Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
9.6K
Systematic Review of the Volume-Outcome Relationship for Radical Prostatectomy.
Jeffrey J Leow1, Eugene K Leong2, Emily C Serrell3
1Division of Urological Surgery and Center for Surgery and Public Health, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Urology, Tan Tock Seng Hospital, Singapore.
European Urology Focus
|July 30, 2017
Summary
Higher surgical volume in radical prostatectomy (RP) is linked to better patient outcomes and lower costs. This updated review confirms that high-volume centers improve results for both traditional and robot-assisted RP procedures.
Area of Science:
- Urology
- Health Services Research
- Surgical Outcomes
Background:
- Radical prostatectomy (RP) is a complex urological procedure.
- Higher surgical volume is associated with improved patient outcomes and reduced healthcare costs.
- Despite evidence, many RPs are still performed at low-volume institutions.
Purpose of the Study:
- To systematically review the association between hospital and surgeon volume and patient/system outcomes after RP.
- To include robot-assisted RP in the analysis of volume-outcome relationships.
- To provide an updated evidence base on surgical volume for RP.
Main Methods:
- Systematic literature review of original articles from PubMed (1959-2016).
- Inclusion criteria: RP, hospital/surgeon volume as predictors, categorized volumes, and measurable outcomes.
- Analysis of 49 publications meeting the selection criteria.
Main Results:
- Most studies show higher surgical volume correlates with better outcomes: reduced mortality, morbidity, complications, length of stay, and readmissions.
- The volume-outcome relationship is consistent in robot-assisted RP.
- Eleven studies assessing both hospital and surgeon volume found neither was an independent predictor when analyzed simultaneously.
Conclusions:
- Contemporary evidence strongly supports the link between high-volume surgery and improved RP outcomes.
- The volume-outcome relationship extends to robot-assisted RP and offers potential cost savings.
- While regionalization is debated, evidence indicates improved short-term outcomes at high-volume centers for RP.
