Patients who have an experienced surgeon perform their radical prostate surgery have a much better prognosis than those who are operated on by less-experienced surgeons, says a new study published in the Journal of the National Cancer Institute.

Those patients with surgeons who had performed more than 250 prostate operations had a probability of recurrence at five years of 10 per cent. But those who were operated on by a surgeon with 10 prostate operations had a probability of recurrence at five years of 17.9 per cent.

The study, The Surgical Learning Curve for Prostate Cancer Control After Radical Prostatectomy, looked at 7,765 prostate cancer patients who underwent radical prostatectomies by one of 72 surgeons at four major U.S. academic medical centres between 1986 and 2003: Memorial Sloan-Kettering Cancer Centre in New York; Baylor College of Medicine in Houston; Wayne State University in Detroit; and Cleveland Clinic in Cleveland.

In the study, the surgeons were assessed for their experience — based on how many radical prostatectomies they had performed — and coded accordingly. The survival rates of the prostate patients were then tracked for prostate cancer recurrence, which involved measuring the serum prostate-specific antigen (PSA) level at various intervals.

A recurrence was defined as having a PSA level of more than 0.4 ng/mL, with other standard tumour characteristics, such as grade, size and lymph node involvement, factored in as well. The survival rates and surgical levels of experience were then compared and analyzed.

The study concludes that as a surgeon's experience increases, patient outcomes following prostate surgery improve, presumably because of improved surgical technique.

"More serious attention should be paid to the issue of surgical quality," reads the report.