title: Contemporary open and robotic radical prostatectomy practice patterns among urologists in the United States.
abstract: OBJECTIVE
  We describe current trends in robotic and open radical prostatectomy in the United States after examining case logs for American Board of Urology certification.
  
  
  METHODS
  American urologists submit case logs for initial board certification and recertification. We analyzed logs from 2004 to 2010 for trends and used logistic regression to assess the impact of urologist age on robotic radical prostatectomy use.
  
  
  RESULTS
  A total of 4,709 urologists submitted case logs for certification between 2004 and 2010. Of these logs 3,374 included 1 or more radical prostatectomy cases. Of the urologists 2,413 (72%) reported performing open radical prostatectomy only while 961 (28%) reported 1 or more robotic radical prostatectomies and 308 (9%) reported robotic radical prostatectomy only. During this 7-year period we observed a large increase in the number of urologists who performed robotic radical prostatectomy and a smaller corresponding decrease in those who performed open radical prostatectomy. Only 8% of patients were treated with robotic radical prostatectomy by urologists who were certified in 2004 while 67% underwent that procedure in 2010. Median age of urologists who exclusively performed open radical prostatectomy was 43 years (IQR 38-51) vs 41 (IQR 35-46) for those who performed only robotic radical prostatectomy.
  
  
  CONCLUSIONS
  While the rate was not as high as the greater than 85% industry estimate, 67% of radical prostatectomies were done robotically among urologists who underwent board certification or recertification in 2010. Total radical prostatectomy volume almost doubled during the study period. These data provide nonindustry based estimates of current radical prostatectomy practice patterns and further our understanding of the evolving surgical treatment of prostate cancer.
authors.affiliation: Department of Surgery, Urology Division, Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah 84112, USA. will.lowrance@hci.utah.edu
authors.forename: William T
authors.initials: WT
authors.lastname: Lowrance
authors.forename: James A
authors.initials: JA
authors.lastname: Eastham
authors.forename: Caroline
authors.initials: C
authors.lastname: Savage
authors.forename: A C
authors.initials: AC
authors.lastname: Maschino
authors.forename: Vincent P
authors.initials: VP
authors.lastname: Laudone
authors.forename: Christopher B
authors.initials: CB
authors.lastname: Dechet
authors.forename: Robert A
authors.initials: RA
authors.lastname: Stephenson
authors.forename: Peter T
authors.initials: PT
authors.lastname: Scardino
authors.forename: Jaspreet S
authors.initials: JS
authors.lastname: Sandhu
mesh_terms: D000367:Age Factors; D002568:Certification; D006801:Humans; D010535:Laparoscopy; D016015:Logistic Models; D008297:Male; D011364:Professional Practice / Q000706:statistics & numerical data / Q000639:trends*; D011468:Prostatectomy / Q000379:methods* / Q000706:statistics & numerical data / Q000639:trends*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012371:Robotics / Q000706:statistics & numerical data / Q000639:trends*; D014481:United States; D014572:Urology / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends