Optimal Site and Number of Biopsy Cores According to Prostate Volume Prostate Cancer Detection in Korea

• Published in: Urology (Ridgewood, N.J.) N.J.), 2007-05, Vol.69 (5), p.902-906
• Main Authors: Shim, Hong Bang, Park, Hyoung Keun, Lee, Sang Eun, Ku, Ja Hyeon
• Format: Article
• Language: English
• Subjects: Adult; Age Factors; Aged; Biological and medical sciences; Biopsy, Needle - methods; Cohort Studies; Gynecology. Andrology. Obstetrics; Humans; Korea; Male; Male genital diseases; Medical sciences; Middle Aged; Neoplasm Staging; Nephrology. Urinary tract diseases; Probability; Prognosis; Prostate-Specific Antigen - blood; Prostatic Neoplasms - diagnostic imaging; Prostatic Neoplasms - mortality; Prostatic Neoplasms - pathology; Risk Assessment; Sensitivity and Specificity; Survival Analysis; Tumor Burden; Tumors; Tumors of the urinary system; Ultrasonography; Ultrasound, High-Intensity Focused, Transrectal; Urinary tract. Prostate gland; Urology
• ISSN: 0090-4295; 1527-9995
• DOI: 10.1016/j.urology.2007.01.043

Objectives To compare different biopsy schemes for detecting prostate cancer in Korean men. Methods A total of 516 men, 40 to 79 years old (mean 64.1 ± 7.8), constituted the study cohort. The patients were divided to quartiles according to prostate volume: 10 to 30, 30.1 to 40, 40.1 to 55, and 55.1 to 162 cm3. Results The cancer detection rates decreased as the prostate volume increased in the quartiles used ( P = 0.001). The group-specific cancer detection rate was 20.0% to 23.8%, 22.1% to 25.6%, 23.6% to 26.6%, and 27.7% in the 6, 8, 10, and 12-core groups, respectively. In all patients undergoing sextant biopsy, laterally placed cores, including the apex, lateral mid-gland, and lateral base, seemed as optimal as the six-core biopsy scheme. The unique cancer detection rates of each biopsy region were low in all patients groups and were not significantly different according to prostate volume quartile. Of the patients with suspicious lesions on transrectal ultrasonography, no cancer was present only in the lesion-directed biopsies, even if sextant biopsy technique was used. Conclusions Our data have shown that lower core schemes can be used with results almost similar to those using the 12-core protocol in this population. A laterally placed, six-core technique is an appropriate biopsy scheme in patients with a prostate volume of less than 40 cm3 . Transrectal ultrasound-directed biopsies can be omitted even when using six-core biopsy protocols because the yield of these biopsies was low. Prebiopsy transrectal ultrasonography is unnecessary because the prostate volume estimation can be done at the same time as the biopsy.