Value of routine transition zone biopsies in men undergoing transrectal ultrasound-guided transperineal prostate biopsies

Objective To determine the utility of routine transition zone biopsies in men undergoing transrectal ultrasound-guided transperineal prostate biopsies. Methods A total of 1956 consecutive patients underwent transrectal ultrasound-guided prostate biopsies for the first time. Systematic biopsies and additional 2 cores transition zone biopsies were performed. The patients were classified to different subgroups according to prostate-specific antigen (PSA), digital rectal examination (DRE) results, transrectal ultrasonography (TRUS) results, prostate volume and PSA density (PSAD). The impact of transition zone biopsies on the prostate cancer detection rate of different groups of patients was analyzed. Results Prostate cancer was detected in 762(39.0%)of the 1956 patients, and 86 of these patients had positive cores only in TZ (P=0.004). The increase in the cancer detection rate by two-core TZ biopsies was 5.8%, 5.5%, 6.8%, 4.3% and 5.8% respectively in patients with PSA level above 10 ng/ml, negative DRE findings, negative TRUS findings, prostate volume over 30ml and PSAD above 0.18 (P<0.05). Conclusion Routine transition zone biopsies may improve the detection rate of prostate cancer in transperineal biopsy protocol.