Number of Procedures Performed Linked to Cancer Recurrence

In surgery, experience counts — and now we have some real numbers to support that premise, thanks to a recent study that tracked the long-term outcome of prostate cancer surgeries against the experience of the surgeons performing them. The results were straightforward: The more experienced the surgeon, the lower the risk that the patient’s cancer would recur.


Prostate cancer is the most frequently diagnosed cancer in men, and surgical removal of the prostate is a common treatment, I was told by Andrew Vickers, PhD, lead study researcher and a statistician at the Memorial Sloan-Kettering Cancer Center in New York City. The operation is called a radical prostatectomy. Dr. Vickers and his research team tracked a total of 7,765 patients treated with radical prostatectomy by one of 72 surgeons at four major academic medical centers. Many patients were followed for more than five years after the surgery to see whether their cancer came back. The researchers analyzed this information relative to the number of radical prostatectomies each surgeon had performed prior to each patient’s case.

The resulting “surgical learning curve” turned out to be a steep one that didn’t begin to plateau until a surgeon had completed approximately 250 prior radical prostatectomies, Dr. Vickers told me. The risk of cancer recurrence in patients operated on by a surgeon who’d performed only 10 previous prostatectomies was higher (18% likelihood of recurrence at five years) than in those patients treated by a surgeon who had performed 250 surgeries (11% rate of recurrence).

Prior to this study, the learning curve for surgery — meaning the concept that improved surgical outcome correlates with a surgeon’s experience performing that specific procedure — was largely theoretical. Now there’s evidence. If you or someone you know require radical prostatectomy, put yourself in experienced hands — specifically ones that have performed a minimum of 250 similar operations. How to find out? Ask.