Surgical Team Composition and Outcomes After Radical Prostatectomy for Prostate Cancer.
- 1Department of Urology, University of Michigan, Ann Arbor, Michigan.
- 2Section of Urology, Department of Surgery, University of Chicago, Chicago, Illinois.
Abstract
Introduction
Physician assistants (PAs) and nurse practitioners (NPs) are increasingly integrated into surgical teams. Although their training varies, existing literature often considers PAs and NPs interchangeable when assessing their impact. The aim of this study was to measure the effects of PA vs NP team composition on surgical outcomes in men with prostate cancer.Methods
We performed a retrospective cohort study using a 20% national sample of traditional Medicare beneficiaries undergoing radical prostatectomy between January 2010 and December 2020. The cohort included patients treated by independent urology groups with at least 1 PA or NP. Groups were stratified into 3 mutually exclusive categories: PA only, NP only, and both PA and NP. Generalized estimating equations measured the association between provider composition and surgical outcomes (ie, postoperative complications, prolonged length of hospitalization, and readmission within 90 days), adjusting for patient-level and group-level variables.Results
Over the study period, 424 independent urology groups with at least 1 PA or NP managed 8975 men undergoing radical prostatectomy. Patient age, race, and comorbidity were similar across team compositions. After adjustment, there was no association between team composition and complications, prolonged length of hospitalization, or readmission (P > .05 for all outcomes). For example, complications occurred in 9.8%, 11.4% and 11.5% of men managed by the PA-only, NP-only, and both PA and NP groups, respectively.Conclusion
Among independent urology practices performing radical prostatectomy, outcomes did not differ between practices employing only PAs, only NPs, or both PAs and NPs. These findings suggest that employing PAs, NPs, or a combination is not associated with differences in postoperative outcomes.
Related
- Comparative outcomes of radical prostatectomy, radiotherapy, and radiotherapy plus androgen deprivation therapy for high-risk and very high-risk prostate cancer: a narrative review
- Feasibility and early outcomes of salvage robot-assisted radical prostatectomy after focal therapy failure for localized prostate cancer
- Results of radical prostatectomy and short-term follow-up of men with ISUP GG 1 and 2 prostate cancer who underwent magnetic resonance imaging-guided active surveillance.
- Predictors of positive surgical margins after robot-assisted radical prostatectomy. A prospective cohort study and a systematic review with meta-analysis.
- Surgical margins and biochemical recurrence after the introduction of robot-assisted radical prostatectomy.
BibTeX
@article{montgomery2026surgical,
title = {{Surgical Team Composition and Outcomes After Radical Prostatectomy for Prostate Cancer.}},
author = {Jazzmyne Montgomery and Anqi Sun and Addison Shay and Samuel Kaufman and Parth Modi and Chad Ellimoottil and Brent Hollenbeck and Vahakn Shahinian},
journal = {JU open plus},
year = {2026},
month = oct,
doi = {10.1097/ju9.0000000000000515},
url = {https://europepmc.org/article/MED/42903415},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Surgical Team Composition and Outcomes After Radical Prostatectomy for Prostate Cancer.
AU - Jazzmyne Montgomery
AU - Anqi Sun
AU - Addison Shay
AU - Samuel Kaufman
AU - Parth Modi
AU - Chad Ellimoottil
AU - Brent Hollenbeck
AU - Vahakn Shahinian
PY - 2026
DA - 2026/10/16
JO - JU open plus
DO - 10.1097/ju9.0000000000000515
UR - https://europepmc.org/article/MED/42903415
AB - Introduction Physician assistants (PAs) and nurse practitioners (NPs) are increasingly integrated into surgical teams. Although their training varies, existing literature often considers PAs and NPs interchangeable when assessing their impact. The aim of this study was to measure the effects of PA vs NP team composition on surgical outcomes in men with prostate cancer.Methods We performed a retrospective cohort study using a 20% national sample of traditional Medicare beneficiaries undergoing radical prostatectomy between January 2010 and December 2020. The cohort included patients treated by independent urology groups with at least 1 PA or NP. Groups were stratified into 3 mutually exclusive categories: PA only, NP only, and both PA and NP. Generalized estimating equations measured the association between provider composition and surgical outcomes (ie, postoperative complications, prolonged length of hospitalization, and readmission within 90 days), adjusting for patient-level and group-level variables.Results Over the study period, 424 independent urology groups with at least 1 PA or NP managed 8975 men undergoing radical prostatectomy. Patient age, race, and comorbidity were similar across team compositions. After adjustment, there was no association between team composition and complications, prolonged length of hospitalization, or readmission (P > .05 for all outcomes). For example, complications occurred in 9.8%, 11.4% and 11.5% of men managed by the PA-only, NP-only, and both PA and NP groups, respectively.Conclusion Among independent urology practices performing radical prostatectomy, outcomes did not differ between practices employing only PAs, only NPs, or both PAs and NPs. These findings suggest that employing PAs, NPs, or a combination is not associated with differences in postoperative outcomes.
SN - 2771-554X
ER -