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Extensive Biopsy Protocol Improves the Detection Rate of Prostate Cancer

Vincent Ravery, Laurent Goldblatt, Benoit Royer, et al.
Abramson Cancer Center of the University of Pennsylvania
Last Modified: November 1, 2001

Reviewers: Li Liu, MD
Source: J Urology Volume 164:393-396, (August) 2000

Précis: More extensive biopsy protocol improved prostate cancer detection rate

Introduction

Transrectal ultrasound (TRUS) and TRUS-guided biopsy have become the method of choice for the detection of prostate cancer, especially when curative treatment is planned. In the recent years, a sis biopsy (sextant) protocol has been used by many centers. However, the sextant method may underestimate the presence of cancer. In this study, the researchers evaluated more extensive biopsy protocol in an attempt to improve the detection rate.

Method

A total of 303 patients underwent TRUS-guided biopsy of prostate gland because of elevated prostate-specific antigen (PSA) levels or an abnormal digital rectal examination. At least 10 biopsies were obtained for each patient, including sextant biopsies.

Results

• The more extensive biopsy protocol improved the detection rate by 6.6% to 38.9% compared with standard sextant biopsies.
• The complication rate was 1%.

Discussion

In this study, adding peripheral cores to the standard sextant needle biopsies of the prostate significantly improves the cancer detection rate. More extensive biopsy appeared to be well tolerated. The optimal number of samples to be taken and the clinical importance of isoechoic cancer seen on ultrasound have yet to be defined. This study did provide some rational arguments for the decision on an optimal protocol.