Charité, Universitätsmedizin Berlin, Urologische Klinik und Hochschulambulanz, Berlin, Germany.
BJU Int. 2012 Feb;109(3):355-9. doi: 10.1111/j.1464-410X.2011.10356.x. Epub 2011 Aug 24.
To report our experience with an Internet-based multicentre database that enables tumour documentation, as well as the collection of quality-related parameters and follow-up data, in surgically treated patients with prostate cancer. The system was used to assess the quality of prostate cancer surgery and to analyze possible time-dependent trends in the quality of care.
An Internet-based database system enabled a standardized collection of treatment data and clinical findings from the participating urological centres for the years 2005-2009. An analysis was performed aiming to evaluate relevant patient characteristics (age, pathological tumour stage, preoperative International Index of Erectile Function-5 score), intra-operative parameters (operating time, percentage of nerve-sparing operations, complication rate, transfusion rate, number of resected lymph nodes) and postoperative parameters (hospitalization time, re-operation rate, catheter indwelling time). Mean values were calculated and compared for each annual cohort from 2005 to 2008. The overall survival rate was also calculated for a subgroup of the Berlin patients.
A total of 914, 1120, 1434 and 1750 patients submitted to radical prostatectomy in 2005, 2006, 2007 and 2008 were documented in the database. The mean age at the time of surgery remained constant (66 years) during the study period. More than half the patients already had erectile dysfunction before surgery (median International Index of Erectile Function-5 score of 19-20). During the observation period, there was a decrease in the percentage of pT2 tumours (1% in 2005; 64% in 2008) and a slight increase in the percentage of patients with lymph node metastases (8% in 2005; 10% in 2008). No time trend was found for the operating time (142-155 min) or the percentage of nerve-sparing operations (72-78% in patients without erectile dysfunction). A decreasing frequency was observed for the parameters: blood transfusions (1.9% in 2005; 0.5% in 2008), postoperative bleeding (2.6%; 1.2%) and re-operations (4.5%; 2.8%). The mean hospitalization time decreased accordingly (10 days in 2005; 8 days in 2008). The examined subcohort had an overall mortality of 1.5% (median follow-up of 3 years).
An Internet-based database system for tumour documentation in patients with prostate cancer enables the collection and assessment of important parameters for the quality of care and outcomes. The participating centres show an improvement in the quality of surgical management, including a reduction of the complication rate.
报告我们在基于互联网的多中心数据库方面的经验，该数据库能够对前列腺癌患者进行肿瘤记录，并收集与质量相关的参数和随访数据。该系统用于评估前列腺癌手术的质量，并分析护理质量的可能随时间变化的趋势。
基于互联网的数据库系统能够标准化地收集 2005-2009 年来自参与泌尿外科中心的治疗数据和临床发现。分析旨在评估相关患者特征（年龄、病理肿瘤分期、术前国际勃起功能指数-5 评分）、术中参数（手术时间、神经保留手术比例、并发症发生率、输血率、切除的淋巴结数量）和术后参数（住院时间、再次手术率、导尿管留置时间）。计算并比较 2005-2008 年每年队列的平均值。还计算了柏林患者亚组的总生存率。
2005 年、2006 年、2007 年和 2008 年分别有 914、1120、1434 和 1750 例患者接受根治性前列腺切除术，并在数据库中记录。研究期间，手术时的平均年龄保持不变（66 岁）。超过一半的患者在手术前已经有勃起功能障碍（国际勃起功能指数-5 评分中位数为 19-20）。在观察期间，T2 肿瘤的比例下降（2005 年为 1%；2008 年为 64%），淋巴结转移患者的比例略有增加（2005 年为 8%；2008 年为 10%）。手术时间（142-155 分钟）或神经保留手术比例（无勃起功能障碍患者为 72-78%）未发现时间趋势。输血频率（2005 年为 1.9%；2008 年为 0.5%）、术后出血（2.6%；1.2%）和再次手术（4.5%；2.8%）的频率降低。相应地，平均住院时间缩短（2005 年为 10 天；2008 年为 8 天）。所检查的亚组总死亡率为 1.5%（中位随访 3 年）。
基于互联网的前列腺癌患者肿瘤记录数据库系统能够收集和评估护理质量和结果的重要参数。参与的中心显示手术管理质量的提高，包括并发症发生率的降低。
