Differences in tumor core distribution between palpable and nonpalpable prostate tumors in patients diagnosed using extensive transperineal ultrasound‐guided template prostate biopsy

Abstract

BACKGROUNDThe authors performed extensive transperineal ultrasound‐guided template prostate biopsies to investigate carcinoma core distribution.METHODSBetween August 2000 and May 2004, 371 men underwent template biopsies. Three hundred twelve patients had not undergone a previous biopsy (first group) and 59 had undergone previous transrectal sextant biopsies (repeat group). Of the 312 patients in the first group, 236 had normal digital rectal examination (DRE) findings (DRE– first group) and 76 patients had an abnormal DRE (DRE+ first group). A mean of 20.1 biopsy cores (range, 9–38 cores) was taken from the entire prostate. The region > 2.0 cm from the rectal face of the prostate was defined as the anterior region and the remaining area was defined as the posterior region.RESULTSIn the DRE– first group, the carcinoma core rate (number of tumor cores/number of biopsy cores) in the anterior region (7.2%) did not differ from that of the posterior region (7.3%) (P = 0.9635). However, in the DRE+ first group, the carcinoma core rate in the posterior region (22.0%) was found to be higher than in the anterior region (13.2%) (P < 0.0001). In the repeat group, the carcinoma core rate in the posterior region (3.1%) was significantly (P = 0.0008) lower than that exhibited in the anterior region (7.2%).CONCLUSIONSThe results of the current study suggest that nonpalpable prostate carcinoma is distributed equally within the entire prostate, although palpable carcinoma is distributed mainly in the posterior region and many of the tumor foci in the anterior region may be missed by a transrectal sextant biopsy. The examination of radical prostatectomy specimens is required to prove these results. Cancer 2005. © 2005 American Cancer Society.

Three-dimensional combination of transrectal and transperineal biopsies for efficient detection of stage T1c prostate cancer

“…[7][8][9][10][11] To be noted, studies using extended TP biopsy protocols have revealed a different cancer core distribution according to the DRE finding. 9,11 Our recent finding that the cancer cores detected by a transrectal ultrasound (TRUS)-guided systematic TP 14-core biopsy distribute apicoanteriorly in stage T1c disease compared with stage T2 disease suggests a potential advantage of TP approach in detecting nonpalpable apicoanterior cancer foci. 9 As far as we know, there has been no study demonstrating a diagnostic advantage of the combination of TR and TP approaches over the single TR or TP approach.…”

Direct comparison between transrectal and transperineal extended prostate biopsy for the detection of cancer

“…3 When compared to TR biopsy, studies on extended transperineal (TP) biopsy have been relatively limited and there has been no consensus on standard extended TP biopsy protocol. [4][5][6][7][8][9][10][11][12][13] The lack of standardization at the moment is related to both TP and TR approaches.…”

Patient-Reported Experience of Modified Transperineal Template Guided Saturation Biopsy Under General Anaesthesia and without Prophylactic Catheterisation

“…They also reported a rate of 4.6% erectile dysfunction 1 month after TPSB, using the IIEF-6 score. Results from other studies are shown in table 2[12,13,14,15,16,17,18,19]. However, a majority relate to retrospective assessments made at 3-4 weeks.…”