Detection of Significant Prostate Cancer According to Anatomical Areas of Sampling Cores Obtained with Transrectal Systematic 12-Core Biopsy

Abstract

Background: To analyze the diagnostic performance of 12-core biopsy in detecting significant prostate cancer (PCa). Patients and Methods: This study included 206 PCa patients who underwent transrectal 12-core biopsy followed by radical prostatectomy. Radical prostatectomy specimens were anatomically divided into 12 areas according to the sampling cores, and the existence of significant cancer, defined by a tumor volume > 0.5 ml, was investigated. The detection rate of significant cancer in each area was calculated as follows: the number of positive core biopsies/the number of areas containing significant cancer × 100. Results: The overall detection rate of significant cancer in all areas was 53.6%. The detection rate was significantly higher in the standard sextant cores than in the additional 6 cores in patients with prostate-specific antigen ≥ 10 ng/ml, clinical stage ≥ T2, or biopsy Gleason score ≥ 7, but not in those with prostate-specific antigen < 10 ng/ml, clinical stage T1c, or biopsy Gleason score ≤ 6. Conclusions: Approximately half of the significant cancers were not accurately detected, and the detection rates in biopsy cores other than the sextant cores appeared to be significantly lower in PCa patients with aggressive features.