Prostate Cancer Detection With Office Based Saturation Biopsy in a Repeat Biopsy Population

Performance of transperineal template-guided mapping biopsy in detecting prostate cancer in the initial and repeat biopsy setting

“…Other large transrectal saturation biopsy series report detection rates of 25-40% in men with earlier negative biopsies. 11,[18][19][20] However, two-thirds to three-quarters of the cancers identified in these studies were Gleason score p6, [18][19][20] supporting the assertion that repeat TRUS biopsy is likely to identify lower grade disease.…”

“…The above point is more striking when compared with men for whom TTMB was used after two or more earlier negative biopsies (Figure 2c). In these men, the cancer detection rate remained high (38%), but the only areas in which cancer was frequently identified were the anterior-most aspects of the gland (regions 1,8,7,9,17,18,19,24). Presumably, with a large enough number of transrectal cores taken (mean of 37.9 prior cores in men with 3 prior biopsies), cancer closer to the rectum is fairly readily discovered.…”

“…For each biopsy core, the template coordinate and the offset from base were recorded. Biopsy regions included posterior prostate (3,4,12,13,21,22), posterior lateral (2,5,11,14,20,23), anterior lateral (1,6,9,10,15,16), anterior apex (19,24), and TZ (7,8,17,18) After completion of all sampling, patients underwent cystoscopic evaluation.…”

Prostate cancer detection by TURP after repeated negative saturation biopsy in patients with persistent suspicion of cancer: a case–control study on 75 consecutive patients

“…SPBx has been recommended in case of repeat biopsy for increasing PCa detection rate: Fleshner and Klotz 16 reported a PCa incidence of 13% in 37 selected patients; Walz et al 17 showed a PCa incidence of 41% in 161 patients; Rabets et al 18 reported 41 and 24% of PCa in 116 men previously submitted to 6 and 10 cores biopsy schemes, respectively; and Rodriguez Alonso et al 19 and Jones et al 20 reported 40.8 and 33% of cancer, respectively. In our experience, 9 PCa detection rate of 22.6% in 75 patients submitted to SPBx after an initial negative extended biopsy was found.…”

Parasagittal biopsies are more important as part of an initial biopsy strategy than as part of a repeat biopsy strategy: observations from a unique population

“…2,3,4 Our group has studied the extended field, saturation biopsy technique using periprostatic local anesthesia as an office-based procedure. 5 We concluded that saturation biopsy improves the diagnostic yield for repeat biopsy, but does not improve results of initial biopsy, so we recommended its use only for the repeat-biopsy population. 6 We previously reported that parasagittal biopsies in the repeat biopsy population had low yield with respect to cancer detection, and that unique parasagittal cancers were rarely (not a single case in our series of 100 patients) found during repeat biopsy.…”