Abstract
ObjectiveTransperineal ultrasound-guided (TPUS) 12-core prostate biopsy was evaluated as an initial strategy for the diagnosis of prostate cancer, The distribution of prostate cancer lesions was assessed with zone-specific biopsy.MethodsFrom January 2010 to December 2012, 287 patients underwent TPUS-guided 12-core prostate biopsy. Multiple cores were obtained from both the peripheral zone (PZ) and the transition zone (TZ) of the prostate. Participants' clinical data and the diagnostic yield of the cores were recorded and prospectively analyzed as a cross-sectional study.ResultsThe diagnostic yield of the 12-core prostate biopsy was significantly higher compared to the 6-core scheme (42.16 vs. 21.6%). The diagnostic yield of the 10-core prostate biopsy was significantly higher compared to the 6-core scheme (37.6 vs. 21.6%). The 12-core scheme improved the diagnostic yield in prostates >50 ml (12-core scheme: 28.1% vs. 10-core scheme: 20.4%; p = 0.034).ConclusionsThe 12-core biopsy scheme is a safe and effective approach for the diagnosis of prostate cancer. TZ biopsies in patients with larger prostates should be included in the initial biopsy strategy.
Highlights
Prostate cancer is the sixth leading cause of cancer-related death among older men in developed countries [1] and is on the rise in developing countries including China
prostate specific antigen (PSA)-based screening has resulted in a significant increase in the detection rate of PCa, its use remains controversial because elevated levels of PSA are not cancer specific
We estimated the diagnostic yield of different biopsy schemes, analyzed the locations within the prostate of the carcinoma-positive cores identified during Transperineal ultrasound-guided (TPUS)-guided extended biopsy, and evaluated the efficacy of TPUS-guided extended biopsy for detecting disease in various locations within the prostate gland
Summary
Prostate cancer is the sixth leading cause of cancer-related death among older men in developed countries [1] and is on the rise in developing countries including China. An ultrasound-guided biopsy uses either a transrectal or transperineal approach to access the prostate Both have been reported to have equal detection rates [5,6,7], the transperineal approach may be preferred under certain circumstances [8]. Biopsy techniques that optimize the number of cores that are sampled, as well as their locations within the prostate gland, may be considered [12] In this prospective analysis, we estimated the diagnostic yield of different biopsy schemes, analyzed the locations within the prostate of the carcinoma-positive cores identified during TPUS-guided extended biopsy, and evaluated the efficacy of TPUS-guided extended biopsy for detecting disease in various locations within the prostate gland
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