Does a surgeon's annual radical prostatectomy volume predict the risk of positive surgical margins and urinary incontinence at one-year follow-up? - Findings from a prospective national study

Abstract Objective. This study aimed to assess the prevalence of positive surgical margins (PSM) and urinary incontinence (UI) in relation to surgeons' annual radical prostatectomy (RP) volume. Material and methods. This national study prospectively assessed 521 preoperatively continent patients with prostate cancer (PCa), scheduled for RP by surgeons with high (>50), medium (20–50) or low annual volume (<20) at 14 urological departments in Norway. Patients responded to UI questions from the Expanded Composite Prostate Cancer Index (EPIC-50) before and 1 year after RP. UI was defined as “use of pad(s)” and/or “a moderate or severe urinary leakage problem (ULP)”. Preoperative prediction of PSMs and UI was explored in multivariate regression analyses with the following independent variables: surgeons' annual RP volume, type of hospital (university versus community), patient's health, sociodemographic features and PCa characteristics. Results. Based on histopathological reports, the overall PSM rate was 26%,...