Honest Question - No Motives - Is this how a surgeon should present back-up for his stats?

I have purposely left out the any info that identifies the dr. or the facility. But this is data from one dr and one facility. This is cut and paste from a report submitted for peer review and education update.

BACKGROUND:
There is a paucity of data on long-term oncologic outcomes for patients undergoing robot-assisted radical prostatectomy (RARP) for prostate cancer (PCa).

OBJECTIVE:
To evaluate oncologic outcomes in patients undergoing RARP at a high-volume tertiary center, with a focus on 5-yr biochemical recurrence-free survival (BCRFS).

DESIGN, SETTING, AND PARTICIPANTS:
The study cohort consisted of 1384 consecutive patients with localized PCa who underwent RARP between September 2001 and May 2005 and had a median follow-up of 60.2 mo. No patient had secondary therapy until documented biochemical recurrence (BCR). BCR was defined as a serum prostate-specific antigen ≥ 0.2 ng/ml with a confirmatory value. BCRFS was estimated using the Kaplan-Meier method. Event-time distributions for the time to failure were compared using the log-rank test. Univariable and multivariable Cox proportional hazards regression models were used to determine variables predictive of BCR.
I
NTERVENTION:
All patients underwent RARP.

MEASUREMENTS:
BCRFS rates were measured.

RESULTS AND LIMITATIONS:
This cohort of patients had moderately aggressive PCa: 49.0% were D'Amico intermediate or high risk on biopsy; however, 60.9% had Gleason 7-10 disease, and 25.5% had ≥ T3 disease on final pathology. There were 189 incidences of BCR (31 per 1,000 person years of follow-up) at a median follow-up of 60.2 mo (interquartile range [IQR]: 37.2-69.7). The actuarial BCRFS was 95.1%, 90.6%, 86.6%, and 81.0% at 1, 3, 5, and 7 yr, respectively. In the patients who recurred, median time to BCR was 20.4 mo; 65% of BCR incidences occurred within 3 yr and 86.2% within 5 yr. On multivariable analysis, the strongest predictors of BCR were pathologic Gleason grade 8-10 (hazard ratio [HR]: 5.37; 95% confidence interval [CI], 2.99-9.65; p < 0.0001) and pathologic stage T3b/T4 (HR: 2.71; 95% CI, 1.67-4.40; p < 0.0001).

CONCLUSIONS:
In a contemporary cohort of patients with localized PCa, RARP confers effective 5-yr biochemical control.

Sonny

I understand what you mean John. But if they have only been doing da Vinci since 2000 that data is not totally there and collected yet.

What I was really referring to was not one methodology over another, but rather the success of the individual doctor and his application of the modality. There has been a lot of discussion here lately about the way some doctors present their numbers and successes. I was thinking that at least a doctor willing to put out the results and follow-ups of all of his procedures over a period of time and in a forthright manner (for peer review) was better than some of the nebulous information that is being put forth by others.

Yep, you are right John. Individual doctors may not have the resources to do it, but sure would make things a little easier in separating the wheat from the chaff.

The copy that I posted here was from one practice though and one facility. Granted it is a rather large facility and has the resources. I think it speaks to the dedication of some in their craft to strive for continued improvement when they track the results like this.

Guess I am just pipe-dreaming. Every day we see new guys come on board here and they all have the same questions. Once they decide how they want to address PCa the bigger question for them then becomes, "Now who do I trust to carry it out?"

Thanks for your input, as always very valuable.

Sonny