Abstract
ObjectivesThere is little data about the clinical value of core length for prostate biopsy (PBx). We investigated the clinical values of various clinicopathological biopsy-related parameters, including core length, in the contemporary multi-core PBx.Patients and MethodsMedical records of 5,243 consecutive patients who received PBx at our institution were reviewed. Among them, 3,479 patients with prostate-specific antigen (PSA) ≤10ng/ml level who received transrectal ultrasound (TRUS)-guided multi (≥12)-core PBx at our institution were analyzed for prostate cancer (PCa). Gleason score upgrading (GSU) was analyzed in 339 patients who were diagnosed with low-risk PCa and received radical prostatectomy. Multivariate logistic regression analyses for PCa detection and prediction of GSU were performed.ResultsThe mean age and PSA of the entire cohort were 63.5 years and 5.4ng/ml, respectively. The overall cancer detection rate was 28.5%. There was no statistical difference in core length between patients diagnosed with PCa and those without PCa (16.1 ± 1.8 vs 16.1 ± 1.9mm, P = 0.945). The core length was also not significantly different (16.4 ± 1.7 vs 16.4 ± 1.6mm, P = 0.889) between the GSU group and non-GSU group. Multivariate logistic regression analyses demonstrated that the core length of PBx did not affect PCa detection in TRUS-guided multi-core PBx (P = 0.923) and was not prognostic for GSU in patients with low-risk PCa (P = 0.356).ConclusionsIn patients undergoing contemporary multi-core PBx, core length may not have significant impact on PCa detection and also GSU following radical prostatectomy among low-risk PCa group.
Highlights
Random prostate biopsy (PBx) is the most important diagnostic tool for detecting prostate cancer (PCa) and provides a cancer detection rate (DR) between 20% and 40% in the initial biopsy setting [1]
There was no statistical difference in core length between patients diagnosed with PCa and those without PCa (16.1 ± 1.8 vs 16.1 ± 1.9mm, P = 0.945)
Multivariate logistic regression analyses demonstrated that the core length of PBx did not affect PCa detection in transrectal ultrasound (TRUS)-guided multi-core PBx (P = 0.923) and was not prognostic for Gleason score upgrading (GSU) in patients with low-risk PCa (P = 0.356)
Summary
Random prostate biopsy (PBx) is the most important diagnostic tool for detecting prostate cancer (PCa) and provides a cancer detection rate (DR) between 20% and 40% in the initial biopsy setting [1]. Target biopsy involves sampling the prostate using imaging modalities, such as real-time elastography or multi-parametric magnetic resonance imaging (MRI). Another possible strategy to increase the cancer DR would be to obtain more prostate tissue through methods, such as extended PBx or saturation PBx [2]. A recent systematic review and meta-analysis reports that the saturation PBx scheme demonstrates a significant advantage in PCa detection [5] Another strategy to increase the cancer DR might be to obtain longer cores with PBx. The length of prostate cores sampled at biopsy is considered to be a quality indicator of PBx [6, 7]. There is a paucity of data in the literature regarding the clinical value of core length in random PBx for detecting cancer
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