Radical prostatectomies for treatment of prostate cancer: trends in a ten-year period in public health services in the city of Sao Paulo, Brazil

Objective: To analyze the characteristics of public health services related to radical prostatectomy, according to hospital volume of surgeries and stratified as academic and nonacademic centers. Methods: An ecological study was conducted using a database available in TabNet platform of the Unified Health System Department of Informatics. Number of surgeries, length of hospital stay, length of stay in intensive care unit, in-hospital mortality rate, and cost of hospitalization were evaluated. The hospitals were divided into three subgroups according to surgery volume (tercile), and results were compared. The same comparisons were made among academic and non-academic centers. We considered academic centers those providing Urology residency program. Results: A total of 11,259 radical prostatectomies were performed in the city of Sao Paulo between 2008 and 2018. We observed a significant trend of increase in radical prostatectomies for treating prostate cancer over the years (p=0.007). The length of stay in intensive care unit, and number of deaths were not statistically different among centers with diverse surgery volume, nor between academic and non-academic centers. However, length of hospital stay was significantly shorter in academic centers (p=0.043), while cost of hospitalization was significantly higher in high-volume center compared to low- (p<0.001) and intermediatevolume centers (p<0.001). Conclusion: Length of hospital stay for radical prostatectomies performed in public services in the city of Sao Paulo was shorter in academic centers, whereas hospitals with a high volume of surgeries showed greater cost of hospitalization.

Automated summary

This study analyzed the characteristics of public health services related to radical prostatectomy, focusing on hospital volume and academic/non-academic centers. The results showed that academic centers had shorter hospital stays, while high-volume centers had higher hospitalization costs. There were no significant differences in other aspects between centers with different surgery volumes and academic/non-academic centers.