Significance of lateral biopsy specimens during transrectal ultrasound‐guided prostate biopsies in Japanese men

Abstract

Objectives: Lateral biopsies are thought to have a better cancer detection rate compared with standard sextant biopsies. This study aimed to determine whether lateral peripheral zone biopsies in Japanese men who underwent transrectal ultrasound-guided prostate biopsies provided a significantly higher cancer detection rate than sextant biopsies. Methods: Between 1999 and 2004, data were collected from 461 men who underwent prostate biopsy and had enough data regarding the performance of lateral biopsies for statistical analysis. There were two categories in this study: (i) patients who underwent sextant prostate biopsies; and (ii) patients who underwent sextant biopsies plus lateral biopsies. Results: Prostate cancer was detected in 141 (30.6%) of 461 patients. It was detected in 24 (22.2%) of 108 patients who underwent sextant biopsies and 117 (33.1%) of 353 patients who underwent sextant plus lateral biopsies. Lateral biopsies were not associated with a statistically higher rate of positive biopsy findings; however, we found a significantly higher ratio of patients with positive findings in those with prostate specific antigen (PSA) levels Յ10 ng/mL (10 of 40, 25%) than in those with PSA levels >10 ng/mL (one of 71, 1.4%) among those who had positive cores only in lateral biopsy samples (P < 0.0001). Conclusions: Lateral biopsies did not show a significantly higher detection ratio of prostate cancer compared to sextant biopsies. However, lateral biopsies were more effective than sextant biopsies in patients with lower PSA levels. Our findings might be useful for the establishment of biopsy strategies to detect prostate cancer, especially in patients with lower PSA levels.

Do Additional Cores from MRI Cancer-Suspicious Lesions to Systematic 12-Core Transrectal Prostate Biopsy Give Better Cancer Detection?

“…Increasing the number of cores may also increase bleeding [27] or other complications [28] . Our previous study showed that adding additional far lateral 2 PZ cores to sextant PZ (8 cores) PBx might yield a higher cancer detection ratio at lower PSA values [29] . However, this study's regimen differed from our previous study and included 4 cores from the TZ.…”

Efficacy of Combination Use of Beta-Lactamase Inhibitor with Penicillin and Fluoroquinolones for Antibiotic Prophylaxis in Transrectal Prostate Biopsy

“…Because TPBX detects prostate cancer in only 20% to 30% of cases, and because most of these patients have organ-confined cancer that may not cause early death [8,23], serious complications from the diagnostic procedure itself should be regarded as unacceptable as mentioned above. Our results of only one febrile complication in 201 consecutive cases and no influence on infection-related laboratory data (WBC and CRP) support an updated methodology for prophylactic medication.…”

The impact of obesity towards prostate diseases

“… 35 , 36 , 37 Prostatitis is found in approximately 10–14% of men of all ages and racial origin and nearly 50% of men at some point in their life encounter this condition. 5 , 19 , 37 , 38 , 39 , 40 , 41 , 42 …”

“…40 This may be caused by gland destruction by inflammatory infiltrates, followed by replacement of the stromal component in symptomatic BPH. 41 However, Dostalova et al 61 revealed that central obesity is associated with significantly higher serum MIC-1 levels, although the exact mechanism is still poorly understood. It is possible that expression of circulating MICs might be in a different concentration than prostatic MICs, especially in the transition zone (site of BPH).…”