Skip to main content
Top
Published in: World Journal of Urology 2/2014

01-04-2014 | Original Article

Prostate cancer detection rates in different biopsy schemes. Which cores for which patients?

Authors: Luigi Cormio, Vincenzo Scattoni, Fabrizio Lorusso, Antonia Perrone, Giuseppe Di Fino, Oscar Selvaggio, Francesca Sanguedolce, Pantaleo Bufo, Francesco Montorsi, Giuseppe Carrieri

Published in: World Journal of Urology | Issue 2/2014

Login to get access

Abstract

Purpose

To determine whether the addition of four paramedian peripheral and four lateral peripheral cores improves the cancer detection rate (CDR) of the extended 10-core biopsy scheme and which patients benefit most from such additional samples.

Methods

One thousand and ninety-one consecutive patients scheduled for first ultrasound-guided transrectal prostate biopsy prospectively underwent a 18-core biopsy scheme, including the traditional sextant (6-core), 4 lateral peripheral (10-core), 4 paramedian peripheral (14-core) and additional 4 lateral peripheral cores (18-core).

Results

The CDR of the 6-, 10-, 14- and 18-core schemes was 33.1, 39.2, 41.6 and 41.8 %, respectively; the difference between the 10- and 6-core scheme reached significance (p < 0.005), whereas that between the 18- or 14- and the 10-core scheme did not. The percentage of tumors diagnosed on the sole basis of the 14-core scheme was significantly greater in patients with low PSA (≤7.2 vs. >7.2 ng/ml: 12.1 vs. 1.8 %; p < 0.0001), large prostate volume (≥50 vs. <50 cc: 3.4 vs. 9.1 %; p = 0.011) and particularly low PSA density (<0.15 vs. ≥0.15: 15.9 vs. 1 %; p < 0.0001). The 18-core scheme did not provide diagnostic advantages in any patients’ population.

Conclusions

The addition of 4 lateral peripheral samples did not increase the CDR of the 10-core biopsy scheme. The addition of four paramedian peripheral samples was beneficial only in patients with PSA density <0.15, in whom the 10-core scheme would have miss almost 16 % of tumors. Since more than half of our patients had low (<0.15) PSA density, these findings seem to be of great clinical relevance.
Literature
1.
go back to reference Hodge KK, McNeal JE, Stamey TA (1989) Ultrasound guided transrectal core biopsies of the palpably abnormal prostate. J Urol 142:66–70PubMed Hodge KK, McNeal JE, Stamey TA (1989) Ultrasound guided transrectal core biopsies of the palpably abnormal prostate. J Urol 142:66–70PubMed
2.
go back to reference Terris MK, Wallen EM, Stamey TA (1997) Comparison of mid-lobe versus lateral systematic sextant biopsies in the detection of prostate cancer. Urol Int 59:239–242PubMedCrossRef Terris MK, Wallen EM, Stamey TA (1997) Comparison of mid-lobe versus lateral systematic sextant biopsies in the detection of prostate cancer. Urol Int 59:239–242PubMedCrossRef
3.
go back to reference Scattoni V, Zlotta A, Montironi R et al (2007) Extended and saturation prostatic biopsy in the diagnosis and characterisation of prostate cancer: a critical analysis of the literature. Eur Urol 52:1309–1322PubMedCrossRef Scattoni V, Zlotta A, Montironi R et al (2007) Extended and saturation prostatic biopsy in the diagnosis and characterisation of prostate cancer: a critical analysis of the literature. Eur Urol 52:1309–1322PubMedCrossRef
4.
go back to reference Siu W, Dunn RL, Shah RB et al (2005) Use of extended pattern technique for initial prostate biopsy. J Urol 174:505–509PubMedCrossRef Siu W, Dunn RL, Shah RB et al (2005) Use of extended pattern technique for initial prostate biopsy. J Urol 174:505–509PubMedCrossRef
5.
go back to reference Guichard G, Larré S, Gallina A et al (2007) Extended 21-sample needle biopsy protocol for diagnosis of prostate cancer in 1000 consecutive patients. Eur Urol 52:430–435PubMedCrossRef Guichard G, Larré S, Gallina A et al (2007) Extended 21-sample needle biopsy protocol for diagnosis of prostate cancer in 1000 consecutive patients. Eur Urol 52:430–435PubMedCrossRef
6.
go back to reference Scattoni V, Raber M, Abdollah F et al (2010) Biopsy schemes with the fewest cores for detecting 95 % of the prostate cancers detected by a 24-core biopsy. Eur Urol 57:1–8PubMedCrossRef Scattoni V, Raber M, Abdollah F et al (2010) Biopsy schemes with the fewest cores for detecting 95 % of the prostate cancers detected by a 24-core biopsy. Eur Urol 57:1–8PubMedCrossRef
7.
go back to reference Eichler K, Hempel S, Wilby J et al (2006) Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review. J Urol 175:1605–1612PubMedCrossRef Eichler K, Hempel S, Wilby J et al (2006) Diagnostic value of systematic biopsy methods in the investigation of prostate cancer: a systematic review. J Urol 175:1605–1612PubMedCrossRef
8.
go back to reference Jones JS, Patel A, Schoenfield L et al (2006) Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J Urol 175:485–488PubMedCrossRef Jones JS, Patel A, Schoenfield L et al (2006) Saturation technique does not improve cancer detection as an initial prostate biopsy strategy. J Urol 175:485–488PubMedCrossRef
9.
go back to reference Pepe P, Aragona F (2007) Saturation prostate needle biopsy and prostate cancer detection at initial and repeat evaluation. Urology 70:1131–1135PubMedCrossRef Pepe P, Aragona F (2007) Saturation prostate needle biopsy and prostate cancer detection at initial and repeat evaluation. Urology 70:1131–1135PubMedCrossRef
10.
go back to reference Heidenreich A, M. Bolla M, S. Joniau S, et al. (2010). Guidelines on prostate cancer. EAU Guidelines:16 Heidenreich A, M. Bolla M, S. Joniau S, et al. (2010). Guidelines on prostate cancer. EAU Guidelines:16
11.
go back to reference Cormio L, Pagliarulo V, Lorusso F et al (2012) Combined perianal-intrarectal (PI) lidocaine-prilocaine (LP) cream and lidocaine-ketorolac gel provide better pain relief than combined PI LP cream and periprostatic nerve block during transrectal prostate biopsy. BJU Int 109:1776–1780PubMedCrossRef Cormio L, Pagliarulo V, Lorusso F et al (2012) Combined perianal-intrarectal (PI) lidocaine-prilocaine (LP) cream and lidocaine-ketorolac gel provide better pain relief than combined PI LP cream and periprostatic nerve block during transrectal prostate biopsy. BJU Int 109:1776–1780PubMedCrossRef
12.
go back to reference Delongchamps NB, de la Roza G, Jones R et al (2009) Saturation biopsies on autopsied prostates for detecting and characterizing prostate cancer. BJU Int 103:49–54PubMedCentralPubMedCrossRef Delongchamps NB, de la Roza G, Jones R et al (2009) Saturation biopsies on autopsied prostates for detecting and characterizing prostate cancer. BJU Int 103:49–54PubMedCentralPubMedCrossRef
13.
go back to reference Ravery V, Dominique S, Panhard X et al (2008) The 20-core prostate biopsy protocol—a new gold standard? J Urol 179:504–507PubMedCrossRef Ravery V, Dominique S, Panhard X et al (2008) The 20-core prostate biopsy protocol—a new gold standard? J Urol 179:504–507PubMedCrossRef
14.
go back to reference Djavan B (2006) Prostate biopsies and vienna nomograms. Eur Urol Suppl 5:500–510CrossRef Djavan B (2006) Prostate biopsies and vienna nomograms. Eur Urol Suppl 5:500–510CrossRef
15.
go back to reference Ficarra V, Novella G, Novara G et al (2005) The potential impact of prostate volume in the planning of optimal number of cores in the systematic transperineal prostate biopsy. Eur Urol 48:932–937PubMedCrossRef Ficarra V, Novella G, Novara G et al (2005) The potential impact of prostate volume in the planning of optimal number of cores in the systematic transperineal prostate biopsy. Eur Urol 48:932–937PubMedCrossRef
16.
go back to reference Inahara M, Suzuki H, Kojima S et al (2006) Improved prostate cancer detection using systematic 14-core biopsy for large prostate glands with normal digital rectal examination findings. Urology 68:815–819PubMedCrossRef Inahara M, Suzuki H, Kojima S et al (2006) Improved prostate cancer detection using systematic 14-core biopsy for large prostate glands with normal digital rectal examination findings. Urology 68:815–819PubMedCrossRef
17.
go back to reference Eskicorapci SY, Baydar DE, Akbal C et al (2004) An extended 10-core ultrasonography guided prostate biopsy protocol improves the detection of prostate cancer. Eur Urol 45:444–448PubMedCrossRef Eskicorapci SY, Baydar DE, Akbal C et al (2004) An extended 10-core ultrasonography guided prostate biopsy protocol improves the detection of prostate cancer. Eur Urol 45:444–448PubMedCrossRef
Metadata
Title
Prostate cancer detection rates in different biopsy schemes. Which cores for which patients?
Authors
Luigi Cormio
Vincenzo Scattoni
Fabrizio Lorusso
Antonia Perrone
Giuseppe Di Fino
Oscar Selvaggio
Francesca Sanguedolce
Pantaleo Bufo
Francesco Montorsi
Giuseppe Carrieri
Publication date
01-04-2014
Publisher
Springer Berlin Heidelberg
Published in
World Journal of Urology / Issue 2/2014
Print ISSN: 0724-4983
Electronic ISSN: 1433-8726
DOI
https://doi.org/10.1007/s00345-012-0989-8

Other articles of this Issue 2/2014

World Journal of Urology 2/2014 Go to the issue