Towards statistical inferences of successful prostate surgery

Prostate cancer continues to be the leading cancer in the United States male population. The options for local therapy have proliferated and include various forms of radiation delivery, cryo-destruction, and novel forms of energy delivery as in high-intensity focused ultrasound. Surgical removal, however, remains the standard procedure for cure. Currently there are little objective parameters that are used to compare the efficiency of each form of surgical removal. As surgeons apply these different surgical approaches, a quality assessment would be most useful, not only with regard to overall comparison of one approach vs. another but also surgeon evaluation of personal surgical performance as they relate to a standard. To this end, we discuss the development of a process employing image reconstruction and analysis techniques to assess the volume and extent of extracapsular soft tissue removed with the prostate. Parameters such as the percent of capsule covered by soft tissue and where present the average depth of soft tissue coverage are assessed. A final goal is to develop software for the purpose of a quality assurance assessment for pathologists and surgeons to evaluate the adequacy/appropriateness of each surgical procedure; laparoscopic versus open perineal or retropubic prostatectomy.