Radical prostatectomy: open versus laparoscopic surgery

Data and measurement considerations

• Indicator results presented here are provided by the Canadian Institute for Health Information (CIHI). They were derived from inpatient and day surgery records from 2013-2014 for men with a documented diagnosis of prostate cancer and who had a procedure indicating prostate removal.
• Provincial results are based on where the surgery occurred, not where the patient lived at the time.
• For more details on the methodology see the Technical Notes from CIHI’s Prostate Cancer Surgery Report (www.cihi.ca/web/resource/en/prostate_surgery_technotes_en.pdf).

Radical Prostatectomy

• Definition: Proportion of prostate cancer cases that underwent radical prostatectomy in 2013 – 2014 by type of surgery
• Numerator: Of the denominator, the total number of prostate cancer cases that underwent radical prostatectomy in 2013 – 2014 by type of surgical approach:
  • Open
  • Robotic laparoscopic
  • Non-robotic laparoscopic
• Denominator: Total number of prostate cancer cases in 2013 – 2014 that underwent a radical prostatectomy procedure
• Data source: Canadian Institute of Health Information (CIHI)
• Measurement timeframe: 2013 – 2014
• Stratification variables: Province
• Provinces submitting data: All
• Province-specific notes: N/A
• General notes:
  1. Results shown by province pertain to the location of surgery, not the province of patient residence.
  2. The denominator consists of all records for male patients of all ages whose discharge record contains a treatment for prostate cancer in the measurement timeframe.
     • • Inclusion criteria:
         1. Discharged from acute care
            • ANALYTICAL_INST_TYPE_CODE in (“1”)
         2. Discharge must have a valid male gender recorded
            • Gender in (“M”)
         3. Has a most responsible diagnosis = C61
         4. Has no past history of prostate cancer (Z85.4)
         5. Has a surgery (one of 1.QT.91) on the index procedure
     
     • Exclusion criteria:
       1. Duplicate records are removed from the analysis. These are identified as discharges with identical values in the following data elements:
          • INST_CODE HEALTH_CARD_ENCRPT_NUM ADMISSION_DATE ADMISSION_TIME
            DISCHARGE_DATE DISCHARGE_TIME HEALTH_CARD_PROV_CODE BIRTHDATE
            GENDER POSTAL_CODE MR_DIAG_ICD10_CODE PRINC_INTERV_CCI_CODE
       2. Newborns, Stillbirths and Cadaveric Donors
          • If ENTRY_CODE not in (“S,” “N”)
          • If ADMISSION_CATEGORY not in (“R”)
       3. Discharges with an invalid encrypted health care number
          • HEALTH_CARD_ENCRYPT_NUM = “0000000000”
       4. All identified procedures with a status attribute code “A” (abandoned)
          • STATUS_ATTRIBUTE not in (“A”)
  3. Volumes are calculated using a methodology similar to that used in CIHI’s report The Delivery of Radical Prostatectomy to Treat Men With Prostate Cancer, with small modifications to allow for annual production, as follows:
     1. The annual Quick Stats tables in the CIHI report include only inpatient records from the DAD, whereas the report included inpatient and day surgery records from the DAD, NACRS and AACRS;
     2. The annual Quick Stats tables count discharges, whereas the report counts episodes;
     3. The annual Quick Stats tables use the variable SUBMITTING_PROV_CODE to determine the location of surgery, whereas the report uses Organization ID (OI) data to determine the location of surgery.

     Due to these modifications, the 2 related products are not directly comparable.