Best Hospitals for Prostate Cancer Surgery
For prostate cancer surgery, you should seek care at high-volume centers with high-volume surgeons, as these institutions consistently deliver superior oncologic and functional outcomes regardless of surgical approach. 1
The Volume-Outcome Relationship
The evidence unequivocally demonstrates that surgeon experience and institutional surgical volume are the strongest predictors of better outcomes across all relevant domains—oncologic control, continence recovery, and potency preservation. 2
- High-volume surgeons at high-volume centers provide superior outcomes for both open and minimally invasive approaches 1
- This volume effect impacts cancer control rates, complication rates, and functional recovery 2
What Defines a High-Volume Center
While the guidelines don't specify exact numerical thresholds, research patterns suggest:
- Centers performing robotic prostatectomy: Look for institutions performing 50+ cases monthly, as this represents the volume seen in established robotic programs 3
- Individual surgeon volume: Seek surgeons with substantial annual case volumes and years of experience with their chosen technique 2
- Academic cancer centers: These institutions typically maintain high volumes and have specialized prostate cancer programs 4
Surgical Approach Considerations
The specific surgical technique (open, laparoscopic, or robotic-assisted) matters less than the volume and experience of the surgeon and center:
- Robotic-assisted radical prostatectomy (RARP) has become the dominant technique in the United States, with over 65% of prostatectomies performed robotically 5
- Oncologic outcomes are equivalent between approaches when performed by experienced surgeons 1, 2, 6
- Functional outcomes (continence and potency) appear similar or slightly favoring robotic approaches in experienced hands, though long-term data remains limited 1, 2, 6
Practical Selection Criteria
When choosing a hospital, prioritize these factors:
- Institutional volume: Centers with dedicated robotic systems and multiple surgeons performing prostatectomy indicate established programs 3
- Surgeon-specific experience: Ask about the surgeon's annual case volume and years performing their technique 2
- Multidisciplinary cancer programs: Centers offering comprehensive prostate cancer care including radiation oncology, medical oncology, and pathology expertise 1
- Academic or NCI-designated cancer centers: These typically maintain the highest volumes and most experienced teams 4
Common Pitfalls to Avoid
- Don't choose based solely on technology availability: A robot doesn't guarantee better outcomes—surgeon experience with that robot does 2, 5
- Avoid low-volume centers: Institutions without robotic systems have seen dramatic drops in prostatectomy volumes (fewer than 10 cases annually), suggesting insufficient experience 3
- Don't delay treatment seeking the "perfect" center: For high-risk disease, timely surgery at a high-volume center is more important than extended searches 1