SYSTEMATIC ANALYSIS OF SATURATION BIOPSY WITH 20 PERIPHERAL CORES AND 4 CORES FROM THE TRANSITION ZONE BASED ON 62 REDUCED BIOPSY SCHEMES AFTER AT LEAST ONE NEGATIVE BIOPSY.

You have accessJournal of UrologyProstate Cancer: Localized IV1 Apr 2010926 SYSTEMATIC ANALYSIS OF SATURATION BIOPSY WITH 20 PERIPHERAL CORES AND 4 CORES FROM THE TRANSITION ZONE BASED ON 62 REDUCED BIOPSY SCHEMES AFTER AT LEAST ONE NEGATIVE BIOPSY Marco Auprich, Stefan Gutschi, Günter Gallè, Martin Pichler, Sebastian Mannweiler, Karl Pummer, and Herbert Augustin Marco AuprichMarco Auprich More articles by this author , Stefan GutschiStefan Gutschi More articles by this author , Günter GallèGünter Gallè More articles by this author , Martin PichlerMartin Pichler More articles by this author , Sebastian MannweilerSebastian Mannweiler More articles by this author , Karl PummerKarl Pummer More articles by this author , and Herbert AugustinHerbert Augustin More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1742AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES According to the recommendations of the European Association of Urology (EAU) a prostate biopsy with at least 10 cores should be performed after an initial negative biopsy. To find the optimal number and location of cores to be sampled during a repeat biopsy in an extended setting, we systematically analyzed a saturation scheme with 20 lateral and 4 transitional cores, performed after at least one prior biopsy. METHODS Clinical and biopsy data were evaluated from 302 patients who underwent repeat biopsies due to persisting or rising prostate-specific antigen (PSA) values (≥2.5-10 ng/ml), suspicious digital rectal examination (DRE) and/or suspicious findings in previous biopsies. Saturation biopsies were performed under sedoanalgesia by three physicians with a biplanar transrectal ultrasound probe and an 18-Gauge biopsy gun (Bard) following a strict topographical scheme. All biopsy samples were evaluated by the same-pathologist (S.M.). The reduction of detection rate was calculated bei McNemar test and Spearman's rho was performed to correlate patient characteristics. RESULTS Biopsy results revealed prostate cancer (PC) in 109 (36.1%) patients and of these, 44 (40.4%) showed Gleason scores ≥7. In 8 (7.3%) patients PC was detected only in the transitional zone. By univariate and multivariate analyses, age, total PSA level and prostate volume were significant predictors (p≤0.01). Analysis of the single cores indicated PC most frequently in the left lateral area and the right transition zone and least often in the basal areas. Systematic analysis of 62 different biopsy schemes with decreasing core numbers found a significant (p<0.031) reduction in PC detection for each reduction in core number except for two 20 biopsy schemes with 16 lateral and 4 transitional cores. CONCLUSIONS Our study shows, that each reduction in the number of biopsy cores taken, decreases the detection rate of PC. Therefore, a saturation biopsy scheme using at least 20 cores should be performed after an initial negative biopsy. If no cores have previously been taken from the transition zone, this region should be included in the following biopsy. Graz, Austria© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e361 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Marco Auprich More articles by this author Stefan Gutschi More articles by this author Günter Gallè More articles by this author Martin Pichler More articles by this author Sebastian Mannweiler More articles by this author Karl Pummer More articles by this author Herbert Augustin More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...