The Efficacy of Routine Sextant Prostate Biopsy Plus Selective Lesion-directed Prostate Biopsy.
- Author:
Seung Hoon CHO
1
;
Sun Il KIM
;
Hae Young PARK
Author Information
1. Department of Urology, College of Medicine, Hanyang University, Seoul, Korea. haeypark@hanyang.ac.kr
- Publication Type:Original Article
- Keywords:
Prostatic cancer;
Biopsy;
Prostate-specific antigen
- MeSH:
Biopsy*;
Digital Rectal Examination;
Humans;
Male;
Prospective Studies;
Prostate*;
Prostate-Specific Antigen;
Prostatic Neoplasms;
Ultrasonography
- From:Korean Journal of Urology
2005;46(7):700-703
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The systematic routine sextant biopsy technique has been widely used in diagnosing prostatic cancer. But this technique may not include an adequate sampling of the prostate. We conducted a prospective study to evaluate the efficacy of the routine sextant prostate biopsy plus selective lesion-directed prostate biopsy method. MATERIALS AND METHODS: 120 men with abnormal digital rectal examination (DRE) and/or prostate-specific antigen (PSA) > or = 4.0ng/ml underwent a total of 122 routine sextant prostate biopsy (RSB) only or RSB plus selective lesion-directed prostate biopsy (SLB). SLB included one of the followings: digital-guided biopsy, hypoechoic lesion-directed biopsy or transitional zone biopsy if there were palpable nodule on DRE, hypoechoic lesion on transrectal ultrasonography (TRUS), or previous history of negative biopsy, respectively. RESULTS: The mean age of patients was 67.6 years (43-86) and the mean PSA level was 7.63ng/ml (0.47-over 155). 37.7% had cancer detected on biopsy. Detection rate in RSB plus SLB group (53.6%, 30 of 56) was higher than in RSB group (24.2%, 16 of 66). In RSB plus SLB group, 4 had cancer detected in SLB core(s) only. The positive rate of biopsy core was higher in the SLB core (72.9% (35/48)) than in the RSB core (54.4% (98/180)) (p= 0.022). CONCLUSIONS: In the presence of a suspicious lesion or the history of a previously negative biopsy, the addition of SLB or transitional zone biopsy may increase the detection rate of prostatic cancer.
