ArticleThe Journal of urology2019
The Impact of Experience on the Risk of Surgical Margins and Biochemical Recurrence after Robot-Assisted Radical Prostatectomy: A Learning Curve Study.
Article in The Journal of urology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 53 papers, 1 of them a synthesis that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
53 citing papers in PubMed, 1 synthesis or guideline pooled it, 94 citations in OpenAlex.
- Clinicopathological Significances of Positive Surgical Resection Margin after Radical Prostatectomy for Prostatic Cancers: A Meta-Analysis.Medicina (Kaunas, Lithuania) · 2022Pooled it
- The learning curve of a novel seven-axis robot-assisted total hip arthroplasty system: a randomized controlled trial.BMC musculoskeletal disorders · 2024Trial
- An interpretable nomogram for positive surgical margin risk after laparoscopic and robot-assisted radical prostatectomy: a single-centre development and internal validation study.Journal of robotic surgery · 2026Article
- Deep-learning segmentation to guide bladder neck recognition in robot-assisted radical prostatectomy.BJU international · 2026Article
- Does an emphasis on urinary continence compromise oncological outcomes after robot-assisted radical prostatectomy?World journal of urology · 2026Article
- Nerve-Sparing in High-Risk Prostate Cancer: Advantages and Pitfalls of Current Strategies and Technologies.Cancers · 2026Review
- Exploring the use of preoperative MRI for assessing the anatomical location of positive surgical margin at robot-assisted radical prostatectomy (RARP).World journal of urology · 2026Article
- Predictors of positive surgical margins after robot-assisted radical prostatectomy. A prospective cohort study and a systematic review with meta-analysis.Central European journal of urology · 2026Article
- Unveiling predictors of positive surgical margins in Retzius-sparing and anterograde robot-assisted radical prostatectomy: insights from a dual-centre learning curve experience.Journal of robotic surgery · 2025Article
- Learning Curves in Robotic Urological Oncological Surgery: Has Anything Changed During the Last Five Years?Cancers · 2025Review
- Robotic vs laparoscopic radical prostatectomy: the impact of surgeon volume on surgical margins and quality of life.American journal of cancer research · 2025Article
- Application of deep learning for semantic segmentation in robotic prostatectomy: Comparison of convolutional neural networks and visual transformers.Investigative and clinical urology · 2024Article
- Surgical Experience and Functional Outcomes after Laparoscopic and Robot-Assisted Partial Nephrectomy: Results from a Multi-Institutional Collaboration.Journal of clinical medicine · 2024Article
- Positive Surgical Margins After Anterior Robot-assisted Radical Prostatectomy: Assessing the Learning Curve in a Multi-institutional Collaboration.European urology oncology · 2024Article
- Deep Learning Model for Real‑time Semantic Segmentation During Intraoperative Robotic Prostatectomy.European urology open science · 2024Article
- Development and validation of a simulation training platform for the ligation of deep dorsal vein complex in radical prostatectomy.Frontiers in oncology · 2024Article
- Transitioning from Da Vinci Si to Xi: assessing surgical outcomes at a high-volume robotic center.World journal of urology · 2023Article
- Robot-Assisted Radical Prostatectomy by Lateral Approach: Technique, Reproducibility and Outcomes.Cancers · 2023Article
- The Surgical Learning Curve for Biochemical Recurrence After Robot-assisted Radical Prostatectomy.European urology oncology · 2023Article
- Learning curve and short-term clinical outcomes of a new seven-axis robot-assisted total knee arthroplasty system: a propensity score-matched retrospective cohort study.Journal of orthopaedic surgery and research · 2023Article
Corrections and comments
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Authors and funding
14 authors at 2 institutions in 2 countries.
Funding
Abstract
purposeImproved cancer control with increasing surgical experience (the learning curve) has been demonstrated for open and laparoscopic prostatectomy. We assessed the relationship between surgical experience and oncologic outcomes of robot-assisted radical prostatectomy. MATERIALS AND
methodsWe analyzed the records of 1,827 patients in whom prostate cancer was treated with robot-assisted radical prostatectomy. Surgical experience was coded as the total number of robotic prostatectomies performed by the surgeon before the patient operation. We evaluated the relationship of prior surgeon experience to the probability of positive margins and biochemical recurrence in regression models adjusting for stage, grade and prostate specific antigen.
resultsAfter adjusting for case mix, greater surgeon experience was associated with a lower probability of positive surgical margins (p = 0.035). The risk of positive margins decreased from 16.7% to 9.6% in patients treated by a surgeon with 10 and 250 prior procedures, respectively (risk difference 7.1%, 95% CI 1.7-12.2). In patients with nonorgan confined disease the predicted probability of positive margins was 38.4% in those treated by surgeons with 10 prior operations and 24.9% in those treated by surgeons with 250 prior operations (absolute risk reduction 13.5%, 95% CI -3.4-22.5). The relationship between surgical experience and the risk of biochemical recurrence after surgery was not significant (p = 0.8).
conclusionsSpecific techniques used by experienced surgeons which are associated with improved margin rates need further research. The impact of experience on cancer control after robotic prostatectomy differed from that in the prior literature on open and laparoscopic radical prostatectomy, and should be investigated in larger multi-institutional studies.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.