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Patient risk: Many clinics lack experience in prostate cancer surgery


Cancer prostate removal should only be done in experienced clinics
According to the German prostate cancer guidelines, surgical removal of the prostate should only be carried out in experienced clinics. However, a recent study shows that this recommendation is largely ignored. Experts call for measures to improve patient care.

Most common cancer in German men
Prostate cancer is the most common cancer in German men and the third most common cause of cancer death. Sufferers undergoing surgery often have a significant impact on their quality of life. In many cases, the men treated are incontinent and impotent after prostate surgery. According to scientists, stem cells injected into the penis can sometimes correct erectile dysfunction.

It is also problematic that the removal of the prostate in cancer often occurs in clinics with little experience. Experts now want to change this.

Recommendation is largely ignored
The German prostate cancer guideline recommends at least 50 operations per year as a reference value for centers that offer complete surgical removal of the prostate. But this recommendation is increasingly being ignored in Germany. This is the result of a study by the Clinic and Polyclinic for Urology at the University Hospital Carl Gustav Carus Dresden.

The scientific work entitled “Robots drive the German radical prostatectomy market” has now been published in the specialist journal “Prostate Cancer and Prostatic Diseases”.

At least 50 interventions per year
According to a report by the Dresden University Hospital, the study shows that hospitals are increasingly performing these radical operations, even though they fall below the recommended minimum number of cases.

The director of studies Dr. Johannes Huber summarized the analysis of all 221,000 interventions in Germany from 2006 to 2013 as follows: “Instead of the centralization of care that is required, more and more patients are operated on in clinics that perform fewer than the recommended 50 interventions per year. Between 2006 and 2013, the proportion of these patients almost doubled from 16 to 28 percent. ”

Binding minimum quantity catalogs abroad
According to Huber, the study shows for the first time that the German healthcare system is moving further and further away from the guideline recommendation for prostate radical surgery by the German Society for Urology. This has an enormous impact on patient safety and quality of care.

The Dresden urologists are therefore calling for measures to centralize patient care. Because surgery in houses with high numbers of cases increases patient safety and less often leads to serious side effects such as impotence or incontinence.

“Many healthcare systems abroad already use mandatory minimum quantity catalogs to centralize complicated operations. In Germany, such a regulation has so far only existed for six procedures such as liver and kidney transplants, surgical interventions on the coronary arteries or in operations on the pancreas and esophagus. - The radical surgery of the prostate is not one of them, ”said Huber.

Radiotherapy is as effective as surgery
Interesting in this context are also new findings that British scientists recently published. According to researchers at Oxford University and the University of Bristol, radiation therapy for prostate cancer is just as effective as surgery. And they have the advantage that there are generally fewer sexual problems or difficulty urinating afterwards. However, this type of treatment is only used by a few sick people. (ad)

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Video: Robotic surgery for prostate cancer (December 2021).