Prostate cancer surgery results better at teaching hospitals

Prostate cancer patients who undergo radical prostatectomy achieve better results at teaching hospitals than at non-academic medical institutions, according to the findings of an international study led by researchers at Henry Ford Hospital’s Vattikuti Urology Institute, Detroit.

"While our findings do not imply that teaching hospitals always provide better care than others, it is obvious that teaching hospitals have certain intrinsic characteristics that would explain the better results," said lead author Quoc-Dien Trinh, MD, of Vattikuti Urology Institute, working with Mani Menon, MD, and co-authors.

The study, which was published in the Journal of Urology (2011; 186:1849-54), drew on data from the U.S. Department of Health & Human Services’ Health Care Utilization Project. The authors reviewed nearly 90,000 radical prostatectomies performed from 2001 to 2007. Of those, nearly 60% were performed at teaching hospitals. Compared with those patients who had RP at non-academic institutions, the authors found that:

• They had fewer complications after surgery.
• There were fewer blood transfusions.
• Hospital stays were shorter.
• Hospitals with heavy caseloads saw similar results for complications, blood transfusions, and length of stay.

The authors suggested that the very nature and characteristics of teaching hospitals might be the reasons for better RP results; most of them offer more subspecialties. In addition, at teaching hospitals, every level of clinical decision-making is subjected to peer review, which may translate into better selection of candidates for RP and of all medical care directly or indirectly related to RP, the authors said.

"From a practical perspective, our results indicate that on average, a more favorable postoperative complication profile, short length of stay, and lower transfusion rate should be expected at academic institutions. However, the choice of an academic institution by itself does not guarantee better outcomes," said Dr. Trinh.

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