I think that I may have a bit of an answer for you on the influence of experience on surgical outcome. about ten years ago I was faced with open heart surgery to correct about four arteries that had become blocked. Diet nor drugs were able to prevent the build up. I was otherwise quite healthy. Anyway, in researching the success factors two things kept coming to the fore front in terms of patient morbidity or relapse. First: How many surgeries did the thoracic surgeon perform in a year. Second: How many surgeries were conducted at the surgical facility. Rest of it was pretty much a wash. Where he went to school, what his grades were, was he left handed or right handed, etc. Clearly experience was the trump card.
Why might this be? Think of your own experience. The more times you do something the better you get at it. Particulary where motor skills are required. Such as playing a musical instrument. I would also believe that a surgeon who sees a lot of patients would be more attuned to the potential risks associated with a particular patients characteristics.
In the case of the facility it was shown that a hospital that did a large number of the procedures was better equipped to handle the procedure and the support personnel were also more experienced in providing acute care following surgery.
In my case I had one of the best heart surgeons around and the hospital was in the top of those rated by US News at the time. I have had no futher complications since that time. In short, I believe in experienced hands and minds.
PSA 21.5 (first and only test resulted from follow up visit to emergency room for kidney stone. first time for kidney stone too)
Gleason 4 + 3
DRE palpable tumor on left side
100% of 12 cores positive for PCa range 35% to 85%
Bone scan clear
Chest x ray clear
CT scan shows potential lymph node involvement in pelvic region
Started Casodex on May 2 and stopped on June 1, 2008
Lupron injection on May 15 and every four months for next two years
PSA test on July 14, 08 after 8 weeks hormone .82
Started IMRT/IGRT on July 10, 2008. 45 treatments scheduled
First 25 to be full pelvic for a total dose of 45 Gray to lymph nodes.
Last 20 to prostate only. Total dose to prostate 81 Gray.
Completed IMRT/IGRT 09/11/08.
Second Lupron shot 09/11/08
Next PSA test by oncologist 03/09