Radical Prostatectomy Trends in the United States: 1998 to 2011
Radical Prostatectomy Trends in the United States: 1998 to 2011
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DOI：
10.1016/j.mayocp.2015.09.018
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发表时间：
2016-01-01
影响因子：
8.9
通讯作者：
Castle, Erik P.
中科院分区：
文献类型：
--
作者：
Tyson, Mark D., II;Andrews, Paul E.;Castle, Erik P.
目的：确定根治性直肠癌切除术（RP）在美国的发病率和分布随时间的推移。患者和方法：我们进行了一系列的时间趋势的横断面分析，使用全国范围内的住院患者样本的成年男性年龄超过45岁谁接受RP之间的1998年1月1日，2011年12月31日。结果：加权估计显示，962，917名男性在研究期间接受了RP。RP的年增长率保持相对稳定，从1998年至1999年期间的每百万人1425 RP到2010年至2011年期间的每百万人1330 RP（下降7%; P = 0.90）。开放性RP的年发生率从1424/100万下降到435/100万（P < .001），而微创RP的年发生率从不到1/100万上升到895/100万（P < .001）。自2006年以来，提供开放式RP的医院减少了18%（从2288到1870; P < .001），而提供微创RP的医院增加了191%（从341到993; P < .001）。每家医院的开放RP病例数中位数下降了7%（从68例下降到63例; P < .001），而提供微创RP的医院的病例数中位数下降了17%（从122例下降到101例; P < .001）。每年提供少于50个微创RP的医院从12%增加到26%（从1240个中的144个增加到11，644个中的3020个; P < .001）。结论：从1998年到2011年，美国RP的人均使用率保持稳定。微创RP使用的快速扩展降低了开放RP的使用率和平均每年的医院病例量。(C)2016年马约医学教育和研究基金会
Objective: To determine the incidence and distribution of radical prostatectomy (RP) in the United States over time.Patients and Methods: We conducted a serial cross-sectional analysis of time trends using the Nationwide Inpatient Sample of adult men older than 45 years who underwent RP between January 1, 1998, and December 31, 2011.Results: Weighted estimates revealed that 962,917 men underwent RP during the study period. The annual rate of RP remained relatively stable, from 1425 RPs per million in the period 1998 to 1999 to 1330 RPs per million in the period 2010 to 2011 (7% decrease; P = .90). The annual rate of open RP decreased from 1424 per million to 435 per million (P < .001), whereas the annual rate of minimally invasive RP increased from less than 1 per million to 895 per million (P < .001). Since 2006, hospitals providing open RP decreased by 18% (from 2288 to 1870; P < .001), whereas hospitals providing minimally invasive RP increased by 191% (from 341 to 993; P < .001). The median open RP caseload per hospital decreased by 7% (from 68 to 63; P < .001), whereas the median caseload for hospitals providing minimally invasive RP declined by 17% (from 122 to 101; P < .001). The hospitals providing fewer than 50 minimally invasive RPs per year increased from 12% to 26% (from 144 of 1240 to 3020 of 11,644; P < .001).Conclusion: Per capita utilization of RP in the United States has remained stable from 1998 to 2011. Rapid expansion of the use of minimally invasive RP has reduced open RP utilization rates and median annual hospital caseload. (C) 2016 Mayo Foundation for Medical Education and Research