Development and Implementation of an Advanced Program for Robotic Treatment of Prostate Cancer—Is Surgical Quality Transferable?

SIMPLE SUMMARY: Robot-assisted radical prostatectomy (RARP) is a surgical treatment option for prostate cancer. The quality of this procedure depends on the surgeon’s operative volume and expertise. When implementing RARP at a new center, it is standard practice to hire a surgeon with appropriate specialty training and expertise. However, since factors other than the surgeon may play a role, the aim of this study was to evaluate the transferability of quality. We compared two different cohorts operated on by the same surgeon who offered extensive training and experience. When analyzing relevant outcome parameters such as duration of surgery, blood loss and the oncologically relevant proportion of positive surgical margins, we found that the results of the second cohort were comparable to those of the first. Thus, we conclude that the quality of RARP is transferable if a surgeon with extensive specialist training and expertise is hired. ABSTRACT: Introduction: Robot-assisted radical prostatectomy (RARP) is a surgical treatment option for prostate cancer (PC). Quality in RARP depends on the surgeon´s operative volume and expertise. When implementing RARP, it is standard practice to hire a pre-trained surgeon. The aim of our study was to investigate the transferability of quality in RARP. Patients and Methods: We analyzed two consecutive retrospective cohorts of 100 and 108 men, respectively, who underwent RARP at two different centers and on whom surgery was performed by the same surgeon. Results: There were more men with high-grade PC in Cohort 1: 25/100 (25.0%) vs. 9/108 (8.3%), p < 0.01, and infiltration of the seminal vesicles was more frequent (23/100 (23.0%) vs. 10/108 (9.2%), p < 0.01). In Cohort 2, the duration of surgery was shorter and blood loss was lower: 149 (134–174) vs. 172 min (150–196), p < 0.01 and 300 (200–400) vs. 131 (99–188) mL, p < 0.01. No difference was found in the proportion of positive surgical margins in the T2 cohort (8.8% vs. 8.2%, p = 1.00). Conclusion: The procedural and oncological outcome parameters of Cohort 2 do not appear to be inferior to the results obtained for the first cohort. The quality of RARP is transferable if a pre-trained surgeon is hired.