BACKGROUND: 68 Ga-prostate-specific membrane antigen (PSMA) positron emission tomography (PET)/computed tomography (CT) is a recommended imaging modality for patients with recurrent prostate cancer (PCa). Its routine implementation before radical prostatectomy (RP) may allow avoiding undertreatment. We aimed to analyze the diagnostic accuracy of 68 Ga-PSMA-PET/CT for pelvic lymph node metastases in a large cohort of patients treated with RP and extended pelvic lymph node dissection (ePLND) for high-risk PCa. METHODS: This is a retrospective analysis of an institutional database of patients who underwent 68 Ga-PSMA-PET/CT before RP and ePLND for high-risk PCa. The diagnostic estimates of 68 Ga-PSMA-PET/CT with 95% confidence intervals (CIs) for lymph node involvement were calculated. RESULTS: We included 165 high-risk PCa patients. The median PSA value was 24.5 ng/mL (range: 6.7-185) and all the patients had biopsy Grade Group 4-5. In total, 46 (28%) of patients had clinical lymph node involvement at 68 Ga-PSMA-PET/CT. A mean number of resected lymph nodes per patient was 22 (range: 15-45) and 149 (4.2%) of all resected nodes were positive for lymph node metastasis at final pathology. The diagnostic estimates for the detection of pN+ disease at RP were as follows: sensitivity 63% (95% CI: 51-75), specificity 97% (95% CI: 91-99), positive predictive value 94% (95% CI: 82-99), and negative predictive value 79% (95% CI: 70-86). The total accuracy of PSMA-PET was 83% (95% CI: 76-88). CONCLUSION: Our analyses support high specificity and positive predictive value of pretreatment 68 Ga-PSMA PET/CT for the detection of pelvic lymph node metastasis in patients treated with RP for high-risk PCa. While a positive finding should be considered as robust indicator for clinical decision-making, a negative result cannot reliably rule out the presence of lymph node involvement in high-risk PCa; there is a need for advanced risk stratification in those patients.

• MeSH
• lidé MeSH
• lokální recidiva nádoru patologie   MeSH
• lymfatické metastázy diagnostické zobrazování   patologie   MeSH
• nádory prostaty * diagnostické zobrazování   chirurgie   patologie   MeSH
• PET/CT * metody   MeSH
• prostata diagnostické zobrazování   chirurgie   patologie   MeSH
• prostatektomie MeSH
• radioizotopy galia MeSH
• retrospektivní studie MeSH
• staging nádorů MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: The role of local therapies including radical prostatectomy (RP) in prostate cancer (PCa) patients with clinical lymphadenopathies on prostate-specific membrane antigen (PSMA) positron emission tomography/computerized tomography (PET/CT) has scarcely been explored. Limited data are available to identify men who would benefit from RP; on the contrary, those more likely to benefit already have systemic disease. OBJECTIVE: We aimed to assess the predictors of prostate-specific antigen (PSA) persistence in surgically managed PCa patients with lymphadenopathies on a PSMA PET/CT scan by integrating clinical, magnetic resonance imaging (MRI), and PSMA PET/CT parameters. DESIGN, SETTING, AND PARTICIPANTS: We identified 519 patients treated with RP and extended lymph node dissection, and who received preoperative PSMA PET between 2017 and 2022 in nine referral centers. Among them, we selected 88 patients with nodal uptake at preoperative PSMA PET (miTxN1M0). OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The outcome was PSA persistence, defined as a PSA value of ≥0.1 ng/ml at the first measurement after surgery. Multivariable logistic regression models tested the predictors of PSA persistence. Covariates consisted of biopsy International Society of Urological Pathology (ISUP) grade group, clinical stage at MRI, and number of positive spots at a PET/CT scan. A regression tree analysis stratified patients into risk groups based on preoperative characteristics. RESULTS AND LIMITATIONS: Overall, lymph node invasion (LNI) was detected in 63 patients (72%) and 32 (36%) experienced PSA persistence after RP. At multivariable analyses, having more than two lymph nodal positive findings at PSMA PET, seminal vesicle invasion (SVI) at MRI, and ISUP grade group >3 at biopsy were independent predictors of PSA persistence (all p < 0.05). At the regression tree analysis, patients were stratified in four risk groups according to biopsy ISUP grade, number of positive findings at PET/CT, and clinical stage at MRI. The model depicted good discrimination at internal validation (area under the curve 78%). CONCLUSIONS: One out of three miN1M0 patients showed PSA persistence after surgery. Patients with ISUP grade 2-3, as well as patients with organ-confined disease at MRI and a single or two positive nodal findings at PET are those in whom RP may achieve the best oncological outcomes in the context of a multimodal approach. Conversely, patients with a high ISUP grade and extracapsular extension or SVI or more than two spots at PSMA PET should be considered as potentially affected by systemic disease upfront. PATIENT SUMMARY: Our novel and straightforward risk classification integrates currently available preoperative risk tools and should, therefore, assist physician in preoperative counseling of men candidates for radical treatment for prostate cancer with positive lymph node uptake at prostate-specific membrane antigen positron emission tomography.

• MeSH
• lidé MeSH
• lymfadenopatie * patologie   chirurgie   MeSH
• lymfatické metastázy patologie   MeSH
• lymfatické uzliny diagnostické zobrazování   chirurgie   patologie   MeSH
• magnetická rezonanční tomografie MeSH
• nádory prostaty * diagnostické zobrazování   chirurgie   patologie   MeSH
• PET/CT metody   MeSH
• pozitronová emisní tomografie MeSH
• prostata diagnostické zobrazování   chirurgie   patologie   MeSH
• prostatektomie MeSH
• prostatický specifický antigen MeSH
• semenné váčky patologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Retence moče způsobené zvětšenou prostatou u staršího nebo polymorbidního muže výrazně snižuje kvalitu života. Standardní operační endoskopické metody mohou být rizikové a je snaha o nalezení minimálně invazivní léčebné metody. Jako nadějná se jeví embolizace arterií prostaty provedená intervenčními radiology. Cílem práce je prezentace klinického případu této úspěšné léčby retence moče.

Urinary retention caused by an enlarged prostate in an elderly or polymorbid man significantly reduces quality of life. Standard operative endoscopic methods can be risky and there is an effort to find a minimally invasive treatment method. Prostate artery embolization performed by interventional radiologists appears promising. The aim of the work is the presentation of a clinical case of this successful treatment of urinary retention.

• MeSH
• hyperplazie prostaty komplikace   MeSH
• komorbidita MeSH
• lidé MeSH
• prostata chirurgie   krevní zásobení   patologie   MeSH
• retence moči * chirurgie   patofyziologie   terapie   MeSH
• senioři nad 80 let MeSH
• terapeutická embolizace MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• Publikační typ
• kazuistiky MeSH

OBJECTIVES: To determine the oncological impact and adverse events of performing simultaneous transurethral resection of bladder tumour (TURB) and transurethral resection of the prostate (TURP), as evidence on the outcomes of simultaneous TURB for bladder cancer and TURP for obstructive benign prostatic hyperplasia is limited and contradictory. PATIENTS AND METHODS: Patients from 12 European hospitals treated with either TURB alone or simultaneous TURB and TURP (TURB+TURP) were retrospectively analysed. A propensity score matching (PSM) 1:1 was performed with patients from the TURB+TURP group matched to TURB-alone patients. Associations between surgery approach with recurrence-free (RFS) and progression-free (PFS) survivals were assessed in Cox regression models before and after PSM. We performed a subgroup analysis in patients with risk factors for recurrence (multifocality and/or tumour size >3 cm). RESULTS: A total of 762 men were included, among whom, 76% (581) underwent a TURB alone and 24% (181) a TURB+TURP. There was no difference in terms of tumour characteristics between the groups. We observed comparable length of stay as well as complication rates including major complications (Clavien-Dindo Grade ≥III) for the TURB-alone vs TURB+TURP groups, while the latest led to longer operative time (P < 0.001). During a median follow-up of 44 months, there were more recurrences in the TURB-alone (47%) compared to the TURB+TURP group (28%; P < 0.001). Interestingly, there were more recurrences at the bladder neck/prostatic fossa in the TURB-alone group (55% vs 3%, P < 0.001). TURB+TURP procedures were associated with improved RFS (hazard ratio [HR] 0.39, 95% confidence interval [CI] 0.29-0.53; P < 0.001), but not PFS (HR 1.63, 95% CI 0.90-2.98; P = 0.11). Within the PSM cohort of 254 patients, the simultaneous TURB+TURP was still associated with improved RFS (HR 0.33, 95% CI 0.22-0.49; P < 0.001). This was also true in the subgroup of 380 patients with recurrence risk factors (HR 0.41, 95% CI 0.28-0.62; P < 0.001). CONCLUSION: In our contemporary cohort, simultaneous TURB and TURP seems to be an oncologically safe option that may, even, improve RFS by potentially preventing disease recurrence at the bladder neck and in the prostatic fossa.

• MeSH
• hyperplazie prostaty * komplikace   MeSH
• lidé MeSH
• lokální recidiva nádoru patologie   MeSH
• nádory močového měchýře * patologie   MeSH
• prostata chirurgie   patologie   MeSH
• retrospektivní studie MeSH
• transuretrální resekce prostaty * škodlivé účinky   metody   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

PURPOSE: Our goal was to compare cancer-specific mortality (CSM) rates between radical prostatectomy (RP) vs external beam radiotherapy (EBRT) in National Comprehensive Cancer Network© (NCCN©) high risk (HR) patients, as well as in Johns Hopkins University (JH) HR and very high risk (VHR) subgroups. MATERIALS AND METHODS: Within the Surveillance, Epidemiology, and End Results database (2010-2016), we identified 24,407 NCCN HR patients, of whom 10,300 (42%) vs 14,107 (58%) patients qualified for JH HR vs VHR, respectively. Overall, 9,823 (40%) underwent RP vs 14,584 (60%) EBRT. Cumulative incidence plots and competing-risks regression addressed CSM after 1:1 propensity score matching (according to age, prostate specific antigen, clinical T and N stages, and biopsy Gleason score) between RP and EBRT patients. All analyses addressed the combined NCCN HR cohort, as well as in JH HR and JH VHR subgroups. RESULTS: In the combined NCCN HR cohort 5-year CSM rates were 2.3% for RP vs 4.1% for EBRT and yielded a multivariate hazard ratio of 0.68 (95% CI 0.54-0.86, p <0.001) favoring RP. In VHR patients 5-year CSM rates were 3.5% for RP vs 6.0% for EBRT, yielding a multivariate hazard ratio of 0.58 (95% CI 0.44-0.77, p <0.001) favoring RP. Conversely, in HR patients no significant difference was recorded between RP vs EBRT (HR 0.7, 95% CI 0.39-1.25, p=0.2). CONCLUSIONS: Our data suggest that RP holds a CSM advantage over EBRT in the combined NCCN HR cohort, and in its subgroup of JH VHR patients.

• MeSH
• analýza přežití MeSH
• brachyterapie statistika a číselné údaje   MeSH
• hodnocení rizik statistika a číselné údaje   MeSH
• kalikreiny krev   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory prostaty krev   diagnóza   mortalita   terapie   MeSH
• program SEER MeSH
• prostata patologie   účinky záření   chirurgie   MeSH
• prostatektomie statistika a číselné údaje   MeSH
• prostatický specifický antigen krev   MeSH
• retrospektivní studie MeSH
• rizikové faktory MeSH
• senioři MeSH
• staging nádorů MeSH
• stupeň nádoru MeSH
• tendenční skóre MeSH
• věkové faktory MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• srovnávací studie MeSH

Východiska: U metastatického karcinomu prostaty (metastatic prostate cancer – mPCa) je standardem léčby systémová léčba v podobě androgen deprivační terapie (ADT), příp. v kombinaci s novými preparáty, tzv. androgen receptor targeting agents (ARTA), nebo docetaxelem. Léčba samotné prostaty u mPCa představuje nové paradigma u tzv. oligometastatického karcinomu prostaty (OMPCa), který je považován za jakýsi mezistupeň mezi lokalizovaným onemocněním a rozsáhlým metastatickým onemocněním. Díky novým diagnostickým metodám je OMPCa stále častěji diagnostikovaným stadiem mPCa. Agresivní lokální terapie by mohla pacientům přinést kromě zlepšení lokální kontroly onemocnění zkrácení ADT i zlepšení přežití. Radioterapie již prokázala onkologický benefit u OMPCa v randomizované studii a nyní je součástí guidelines k léčbě tzv. low volume de novo mPCa. Cytoredukční prostatektomie (CP) zatím na výsledky randomizovaných studií čeká, nicméně již existují retrospektivní data podporující tuto léčebnou modalitu. Bylo publikováno několik populačních studií, které prokázaly benefit CP. Menší retrospektivní práce prokázaly bezpečnost provedení CP v klinické praxi. V současné době probíhá několik prospektivních randomizovaných studií zkoumajících tuto léčebnou modalitu. Celý koncept CP u OMPCa je však stále opředen mnoha nevyřešenými otázkami, jako je definování vhodného pacienta a role další formy lokální terapie cílené na metastázy. Cíl: Záměrem tohoto sdělení je podat přehled klíčových publikovaných nebo probíhajících studií týkajících se CP ve vztahu nejen k funkčním a onkologickým výsledkům, ale i indikačním kritériím a designu jednotlivých studií.

Background: In metastatic prostate cancer (mPCa), the standard treatment involves systemic treatment including androgen deprivation therapy (ADT), possibly in combination with new drugs called androgen receptor targeting agents (ARTA) or docetaxel. The treatment of the prostate itself in mPCa represents a new paradigm in the so-called oligometastatic prostate cancer (OMPCa), which is considered to be a kind of intermediate stage between localized disease and extensive metastatic disease. Thanks to new diagnostic methods, OMPCa is an increasingly frequently diagnosed stage of mPCa. In addition to improving local control of the disease, aggressive local therapy could lower the need for ADT, or improve survival. Radiotherapy has already demonstrated the oncological benefit of OMPCa in a randomized study and is now part of the guidelines for the treatment of low volume de novo mPCa. Cytoreductive prostatectomy (CP) is still awaiting the results of randomized trials; however, retrospective data already exist to support this treatment modality. Several population-based studies have been published that have demonstrated the benefit of CP. Minor retrospective works have demonstrated the safety of CP in clinical practice. Several prospective randomized trials investigating this treatment modality are currently underway. However, the whole concept of CP in OMPCa is still shrouded in many unresolved issues such as the definition of a suitable patient and the role of another form of local therapy targeted to metastases. Purpose: This article aims to provide an overview of key published or ongoing studies related to CP in relation not only to functional and oncological results but also to the indication criteria and design of individual studies.

• MeSH
• antagonisté androgenů * farmakologie   terapeutické užití   MeSH
• cytoredukční chirurgie * metody   MeSH
• lidé MeSH
• metastázy nádorů MeSH
• nádory prostaty * chirurgie   patologie   MeSH
• prospektivní studie MeSH
• prostata chirurgie   patologie   MeSH
• prostatektomie metody   MeSH
• retrospektivní studie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• přehledy MeSH

BACKGROUND: The pathological stage of prostate cancer with high-risk prostate-specific antigen (PSA) levels, but otherwise favorable and/or intermediate risk characteristics (clinical T-stage, Gleason Grade group at biopsy [B-GGG]) is unknown. We hypothesized that a considerable proportion of such patients will exhibit clinically meaningful GGG upgrading or non-organ confined (NOC) stage at radical prostatectomy (RP). MATERIALS AND METHODS: Within the Surveillance, Epidemiology, and End Results database (2010-2015) we identified RP-patients with cT1c-stage and B-GGG1, B-GGG2, or B-GGG3 and PSA 20-50 ng/ml. Rates of GGG4 or GGG5 and/or rates of NOC stage (≥ pT3 and/or pN1) were analyzed. Subsequently, separate univariable and multivariable logistic regression models tested for predictors of NOC stage and upgrading at RP. RESULTS: Of 486 assessable patients, 134 (28%) exhibited B-GGG1, 209 (43%) B-GGG2, and 143 (29%) B-GGG3, respectively. The overall upgrading and NOC rates were 11% and 51% for a combined rate of upgrading and/or NOC stage of 53%. In multivariable logistic regression models predicting upgrading, only B-GGG3 was an independent predictor (odds ratio [OR]: 5.29; 95% confidence interval [CI]: 2.21-14.19; p < 0.001). Conversely, 33%-66% (OR: 2.36; 95% CI: 1.42-3.95; p = 0.001) and >66% of positive biopsy cores (OR: 4.85; 95% CI: 2.84-8.42; p < 0.001), as well as B-GGG2 and B-GGG3 were independent predictors for NOC stage (all p ≤ 0.001). CONCLUSIONS: In cT1c-stage patients with high-risk PSA baseline, but low- to intermediate risk B-GGG, the rate of upgrading to GGG4 or GGG5 is low (11%). However, NOC stage is found in the majority (51%) and can be independently predicted with percentage of positive cores at biopsy and B-GGG.

• MeSH
• lidé MeSH
• nádory prostaty * patologie   chirurgie   MeSH
• prostata patologie   chirurgie   MeSH
• prostatektomie metody   MeSH
• prostatický specifický antigen * MeSH
• staging nádorů MeSH
• stupeň nádoru MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

BACKGROUND: The role of isoforms of prostate specific antigen (PSA) and other kallikrein-related markers in early detection of biochemical recurrence (BCR) after radical prostatectomy (RP) is not well known and serum PSA is currently used in preoperative risk nomograms. OBJECTIVE: The aim of this research was to study pre- and early postoperative levels of important PSA isoforms and human kallikrein-2 to determine their ability to predict BCR and identify disease persistence (DP). METHODS: This study included 128 consecutive patients who underwent RP for clinically localized prostate cancer. PSA, fPSA, %fPSA, [-2]proPSA, PHI and hK2 were measured preoperatively, at 1 and 3 months after RP. We determined the ability of these markers to predict BCR and identify DP. RESULTS: The DP and BCR rate were 11.7%and 20.3%respectively and the median follow up was 64 months (range 3-76 months). Preoperatively, the independent predictors of BCR were PSA (p-value 0.029), [-2]proPSA (p-value 0.002) and PHI (p-value 0.0003). Post-RP, PSA was the single marker correlating with BCR, both at one (p-value 0.0047) and 3 months (p-value 0.0004). PSA, fPSA, [-2]proPSA and PHI significantly correlated to DP at 1 and 3 months post-RP (p-value <  0.05), although PSA had the most significant existing correlation (p-value <  0.0001). CONCLUSIONS: [-2]proPSA and PHI are preoperative predictors of BCR and DP that outperform the currently used serum PSA. At the early postoperative period there is no additional benefit of the other markers tested.

• MeSH
• časná detekce nádoru MeSH
• lidé středního věku MeSH
• lidé MeSH
• lokální recidiva nádoru krev   diagnóza   genetika   MeSH
• nádorové biomarkery krev   MeSH
• nádory prostaty krev   diagnóza   genetika   chirurgie   MeSH
• nomogramy MeSH
• pooperační období MeSH
• prostata patologie   chirurgie   MeSH
• prostatektomie MeSH
• prostatický specifický antigen krev   MeSH
• protein - isoformy krev   genetika   MeSH
• senioři MeSH
• stupeň nádoru MeSH
• tkáňové kalikreiny krev   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Přes pokroky ve využití nových biomarkerů a zobrazovacích technikách hraje biopsie v diagnostice karcinomu prostaty (PCa) stále stěžejní úlohu. V poslední době jsme, kromě stále většího využití MRI/TRUS navigace odběru vzorků, svědky i tendence návratu k transperineálnímu přístupu při biopsii prostaty. Transperineální biopsie prostaty (TPBxP) slibuje vyhnout se komplikacím spojeným s transrektálním odběrem vzorků, zejména riziku infekce. Dále TPBxP nabízí lepší přístup k anteriorním částem prostaty, což je výhodné pro zde uložená ložiska popsaná na MRI či u pacientů po předchozích opakovaných transrektálních biopsiích, u kterých dosud převažoval odběr z dorzální části prostaty, která je při transrektální biopsii (TRBxP) přístupnější. Jelikož se jedná o dosud málo prováděný zákrok, nabízíme v následujícím textu přehled literatury pojednávající o TPBxP dostupné v databázi PubMed. Dle nalezené literatury je TPBxP metodou, která je dobře proveditelná v celkové i lokální anestezii a je pacienty dobře tolerována. Záchyt karcinomu prostaty je srovnatelný s transrektální biopsií, TPBxP nicméně dosahuje vyššího záchytu karcinomu v anteriorní části prostaty. Po TPBxP dochází dle mnohých analýz k nižšímu výskytu infekčních komplikací a krvácení z rekta, výskyt ostatních komplikací je obdobný jako u transrektální biopsie prostaty.

Despite advances in imaging methods and the use of novel biomarkers, prostate biopsy still plays a vital part in prostate cancer diagnostics. Along with the widespread use of MRI/TRUS fusion guided biopsies we are recently witnessing a resurgence of transperineal approach in prostate biopsy. Transperineal prostate biopsy (TPBxP) offers to avoid infectious complications by omitting the transrectal approach. Furthermore, TPBxP offers to improve the detection rate in the, sometimes undersampled, anterior part of the gland in patients after previous negative transrectal biopsies or with anterior prostate lesions visible on MRI. As TPBxP is not yet widely used in clinical practice, in this text we aim to offer a review of literature concerning TPBxP available in the PubMed database. According to the available data, TPBxP is easy to perform under general or local anaesthesia and is well tolerated by patients. Detection rate of prostate cancer is similar to that of the transrectal approach, except in the anterior parts of the prostate where TPBxP detects more cancer. TPBxP also seems to have less infectious complications and cases of rectal bleeding after biopsy. The incidence of other prostate biopsy complications is similar between transrectal and transperineal approach.

• Klíčová slova
• transperineální biopsie prostaty,
• MeSH
• biopsie * metody   MeSH
• lidé MeSH
• lokální anestezie metody   MeSH
• nádory prostaty * diagnóza   MeSH
• pooperační komplikace MeSH
• prostata chirurgie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• přehledy MeSH

CONTEXT: The impact of surgeon and hospital volume on outcomes after radical prostatectomy (RP) for localised prostate cancer (PCa) remains unknown. OBJECTIVE: To perform a systematic review on the association between surgeon or hospital volume and oncological and nononcological outcomes following RP for PCa. EVIDENCE ACQUISITION: Medline, Medline In-Process, Embase, and the Cochrane Central Register of Controlled Trials were searched. All comparative studies for nonmetastatic PCa patients treated with RP published between January 1990 and May 2020 were included. For inclusion, studies had to compare hospital or surgeon volume, defined as caseload per unit time. Main outcomes included oncological (including prostate-specific antigen persistence, positive surgical margin [PSM], biochemical recurrence, local and distant recurrence, and cancer-specific and overall survival) and nononcological (perioperative complications including need for blood transfusion, conversion to open procedure and within 90-d death, and continence and erectile function) outcomes. Risk of bias (RoB) and confounding assessments were undertaken. Both a narrative and a quantitative synthesis were planned if the data allowed. EVIDENCE SYNTHESIS: Sixty retrospective comparative studies were included. Generally, increasing surgeon and hospital volumes were associated with lower rates of mortality, PSM, adjuvant or salvage therapies, and perioperative complications. Combining group size cut-offs as used in the included studies, the median threshold for hospital volume at which outcomes start to diverge is 86 (interquartile range [IQR] 35-100) cases per year. In addition, above this threshold, the higher the caseload, the better the outcomes, especially for PSM. RoB and confounding were high for most domains. CONCLUSIONS: Higher surgeon and hospital volumes for RP are associated with lower rates of PSMs, adjuvant or salvage therapies, and perioperative complications. This association becomes apparent from a caseload of >86 (IQR 35-100) per year and may further improve hereafter. Both high- and low-volume centres should measure their outcomes, make them publicly available, and improve their quality of care if needed. PATIENT SUMMARY: We reviewed the literature to determine whether the number of prostate cancer operations (radical prostatectomy) performed in a hospital affects the outcomes of surgery. We found that, overall, hospitals with a higher number of operations per year have better outcomes in terms of cancer recurrence and complications during or after hospitalisation. However, it must be noted that surgeons working in hospitals with lower annual operations can still achieve similar or even better outcomes. Therefore, making hospital's outcome data publicly available should be promoted internationally, so that patients can make an informed decision where they want to be treated.

• MeSH
• chirurgové zásobování a distribuce   MeSH
• hodnocení výsledků zdravotní péče MeSH
• lidé MeSH
• lokální recidiva nádoru MeSH
• nádory prostaty chirurgie   MeSH
• nemocnice MeSH
• poskytování zdravotní péče normy   MeSH
• pracovní zátěž MeSH
• prostata chirurgie   MeSH
• prostatektomie škodlivé účinky   MeSH
• specializovaná centra se zvyšujícím se počtem výkonů a tím zvyšující se kvalitou léčby MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• systematický přehled MeSH