Investigation of Optimal Prostate Biopsy Schemes for Chinese Patients with Different Clinical Characteristics

Abstract

Purpose: To investigate the optimal schemes of prostate biopsy according to prostate volume (PV), age and transrectal ultrasound (TRUS) status in Chinese men. Methods: 923 consecutive patients who underwent initial TRUS-guided systematic 12-core prostate biopsy (12PBx) were enrolled in this study. The 12PBx was obtained by overlapping of conventional sextant, lateral base, mid-gland of peripheral zone and apex. Each sample was individually marked and inked before fixation. Patients were divided into 8 subgroups on the basis of independent risk factors investigated using logistic regression model. Subsequently, 12PBx was defined as self-control for the analysis of biopsy schemes (6-, 8- and 10PBx) on individual core basis. The prostate cancer detection rates (CDRs) of 6-, 8-, 10- and 12PBx were compared for each individual subgroup. Results: The 12PBx detected 253 (27.4%) cases of prostate cancer (PCa), of which 67.2, 47.1 and 61.3% were located in the base, mid-gland and apex, respectively. Multivariate analysis indicated that age, TRUS status and PV were independent risk factors for PCa detection. CDR increased with increasing biopsy cores. However, for patients with age ≥65 years, positive TRUS and PV <38.5 cm³, CDR of 8PBx (30.6%) was similar to 10PBx (32.2%) and 12PBx (32.2%); for patients with age ≥65 years, negative TRUS and PV <38.5 cm³ or ones with age ≥65 years, positive TRUS and PV ≥38.5 cm³, 10PBx was as effective as 12PBx in detecting PCa (27.8, 27.5 vs. 28.9, 29.3%, respectively). Conclusion: Age, TRUS status and PV were independent risk factors for PCa detection. Traditional sextant biopsy is not recommended. 8-, 10-, or 12PBx as an individual biopsy scheme might be adopted according to these risk factors for Chinese patients.

Increasing Prostate-Specific Antigen Levels Differently Influence Prostate Cancer Detection Rates of Two Different 12-Core Prostate Biopsy Schemes

“…As reported by others [19], we found older age and lower prostate volume, as well as an abnormal DRE finding, to be independently associated with higher cancer detection rates. In the present sample, the relationship between the two evaluated methods (i.e.…”

3-Tesla magnetic resonance imaging improves the prostate cancer detection rate in transrectral ultrasound-guided biopsy

“…However, clinical practice suggests that systematic biopsy may be associated with a high false-negative rate ( 1 ), and systematic repeat biopsy does not give a satisfactory cancer detection rate ( 2 ), in addition to increasing the risk of complications and discomfort to the patient. Additional targeted biopsy in suspicious areas identified by TRUS may improve detection rates, as the sensitivity of conventional TRUS for cancer lesions is relatively low ( 3 , 4 ). Even new imaging techniques such as sonoelastography and contrast-enhanced TRUS do not provide a considerable benefit to the diagnosis of PCa ( 5 , 6 ).…”