Prostate Biopsy Quality Is Independent of Needle Size: A Randomized Single-Center Prospective Study

Cicione, Antonio; Cantiello, Francesco; Nunzio, Cosimo De; Tubaro, Andrea; Damiano, Rocco

doi:10.1159/000339250

Cited by 12 publications

(7 citation statements)

References 31 publications

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“…However, the crude detection rates for both protocols (29.4 and 31.3%, respectively) were comparable to those reported for saturation biopsy protocols in patients with at least one negative previous biopsy [14,15]. Finally, since the cancer detection rate does not seem to be influenced by the needle size (similar rates with 16-gauge and 18-gauge needles) [16], the fact that we exclusively used an 18-gauge needle is unlikely to have biased the present findings. Therefore, it seems reasonable to consider that the present observations have also attained a fair level of external validity.…”

Section: Discussionsupporting

confidence: 55%

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

Lodeta

Benkö²,

Trkulja³

2013

Urol Int

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Objective: To compare two 12-core transrectal ultrasound-guided prostate biopsy schemes in respect to cancer detection rates. Methods: Retrospective, single-center analysis of consecutive patients (n = 897) who underwent prostate biopsy (S1) with all 12 cores from far lateral areas (n = 269) or prostate biopsy (S2) with 6 cores from parasagittal and 6 from far lateral areas (n = 628). Results: Crude cancer detection rates with S1 and S2 were similar (39.0 and 38.9% for the first biopsy and 29.4 and 31.3% for repeated biopsies, respectively). Abnormal digital rectal exam, lower prostate volume and higher prostate-specific antigen (PSA) levels were independently associated with higher odds of cancer detection. Regarding first biopsies (n = 747), there was significant interaction between biopsy scheme and PSA (p < 0.001). Overall, the adjusted odds of cancer detection were higher with S1 (S1/S2 odds ratio = 2.54, 95% CI: 1.12-5.74), but the S1-S2 relationship was conditional on PSA: odds ratios progressively increased with increasing PSA from 0.64 (95% CI: 0.40-1.02) at PSA 5 ng/ml to 39.1 (95% CI: 2.71-566) at 75 ng/ml. Conclusion: Higher PSA levels increase the probability of cancer detection with 12-core prostate biopsies, but relative efficiency of different procedures appeared conditional on the PSA level. Data suggest that PSA levels should be considered in the choice of prostate biopsy sampling scheme.

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Section: Discussionsupporting

confidence: 55%

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

Lodeta

Benkö²,

Trkulja³

2013

Urol Int

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“…For those taking antiplatelet drugs, though the bleeding risk was considered low ( 15 , 16 ), we discontinued the use of these drugs prior to the biopsy in order to exclude that variable. As for other factors, several reports showed that the incidence of complications did not correlate in prostate biopsy when considering the size of the biopsy needle or the number of biopsies ( 17 , 18 ). In cases of patients with hemorrhoids, they did have a bleeding risk because the rectal venous plexus was enlarged ( 12 ).…”

Section: Discussionmentioning

confidence: 99%

Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

2015

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Objectives To examine the usefulness of an absorbable hemostatic gelatin sponge for hemostasis after transrectal prostate needle biopsy.Subjects and Methods The subjects comprised 278 participants who underwent transrectal prostate needle biopsy. They were randomly allocated to the gelatin sponge insertion group (group A: 148 participants) and to the non-insertion group (group B: 130 participants). In group A, the gelatin sponge was inserted into the rectum immediately after biopsy. A biopsy-induced hemorrhage was defined as a case in which a subject complained of bleeding from the rectum, and excretion of blood clots was confirmed. A blood test was performed before and after biopsy, and a questionnaire survey was given after the biopsy.Results Significantly fewer participants in group A required hemostasis after biopsy compared to group B (3 (2.0%) vs. 11 (8.5%), P=0.029). The results of the blood tests and the responses from the questionnaire did not differ significantly between the two groups. In multivariate analysis, only “insertion of a gelatin sponge into the rectum” emerged as a significant predictor of hemostasis.Conclusion Insertion of a gelatin sponge into the rectum after transrectal prostate needle biopsy significantly increases hemostasis without increasing patient symptoms, such as pain and a sense of discomfort.

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“…According to the literature and the major international guidelines, the 12 cores extended scheme remains the recommended standard in the initial PBx setting [ 1 , 3 ]. Despite the aforementioned assumption about needle size, it has also been reported that needle size does not affect the PCa DR and sample quality [ 22 , 23 ]. Therefore, additional sampling does not guarantee increased diagnosis of PCa, although sampling an adequate amount of prostate tissue beyond the standard is essential for exact pathological diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Clinical Value of Core Length in Contemporary Multicore Prostate Biopsy

et al. 2015

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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.

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Prostate Biopsy Quality Is Independent of Needle Size: A Randomized Single-Center Prospective Study

Cited by 12 publications

References 31 publications

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

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

Effect on hemostasis of an absorbable hemostatic gelatin sponge after transrectal prostate needle biopsy

Clinical Value of Core Length in Contemporary Multicore Prostate Biopsy

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