Eleven studies with more than 300,000 participants were included in the review.
There were 4 studies on radical prostatectomy. Two out of 3 studies found a statistically significant reduction in mortality rates with increasing hospital volume; 1 study found no difference in mortality rates.
There were 4 studies on radical cystectomy. One study demonstrated a statistically significant decrease in mortality with increasing hospital volume, while 2 studies showed a non significant decrease in mortality.
There were 4 studies on radical nephrectomy. No consistent relationship between mortality and hospital volume was found: 1 study found a statistically significant decrease in mortality with increasing hospital volume, 1 study showed no difference, and 1 study found an increase. Surgeon volume.
There were 3 studies on radical prostatectomy. One study demonstrated a statistically significant reduction in mortality with higher surgeon volume, while another demonstrated an increase in mortality although this was not statistically significant. Two studies found improved outcomes, including post-operative and longer term complications and length of stay, with increasing surgeon volume.
There was 1 study of radical cystectomy. A statistically significant decrease in mortality was shown with increasing surgeon volume.
Combined hospital and surgeon volume (3 studies).
One study found small but statistically significant reductions in mortality after radical cystectomy in hospitals and surgeons with greater volume. Another study found that after radical prostatectomy, outcomes other than mortality were significantly improved with high-volume surgeons when hospital and surgeon volume were included in the same model. The final study demonstrated that post-operative complications and later urinary complications were reduced in high-volume hospitals with high-volume surgeons.