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• W1963652802 abstract "No AccessJournal of UrologyAdult Urology1 Jun 2012Core Length in Prostate Biopsy: Size Matters Can Öbek, Tünkut Doğanca, Sinan Erdal, Sarper Erdoğan, and Haydar Durak Can ÖbekCan Öbek Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author , Tünkut DoğancaTünkut Doğanca Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author , Sinan ErdalSinan Erdal Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey Department of Public Health, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author , Sarper ErdoğanSarper Erdoğan Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey Department of Public Health, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author , and Haydar DurakHaydar Durak Department of Pathology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.01.075AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The diagnostic yield of prostate biopsy is limited. Increasing the number of cores enhances the cancer detection rate by sampling additional sites and obtaining more tissue. An alternative way to inspect more tissue would be to obtain longer cores. However, the impact of biopsy core length on cancer detection rate is an undervalued topic. We assessed the role of biopsy core length in prostate biopsy and determined the minimal tissue length to serve as quality assurance. Materials and Methods: We retrospectively analyzed the records of 331 patients who underwent transrectal ultrasound guided initial prostate biopsy with 12 to 18 cores. The biopsy procedure and pathological evaluation were standardized. Core length was compared in patients with vs without cancer. Statistical analysis was done to determine a minimally acceptable cutoff for biopsy length. Results: We analyzed data on 245 patients. The overall cancer detection rate was 30.2%. Mean core length in patients with vs without cancer was 12.3 ± 2.6 vs 11.4 ± 2.4 mm (p = 0.015). Thus, core length was significantly longer in patients with cancer. Core length greater than 11.9 mm was associated with an increased prostate cancer detection rate (OR 2.57, 95% 1.46–4.52). The cancer detection rate for cores less vs greater than 11.9 mm was 23% vs 39%. Conclusions: Needle core length is an important morphometric parameter of transrectal prostate biopsy that directly influences the cancer detection rate. Results suggest a core length of greater than 11.9 mm as a cutoff for quality assurance. References 1 : Extended peripheral zone biopsy schemes increase cancer detection rates and minimize variance in prostate specific antigen and age related cancer rates: results of a community multi-practice study. J Urol2003; 169: 125. Link, Google Scholar 2 : Optimizing prostate cancer detection: 8 versus 12 core biopsy protocol. J Urol2009; 182: 1329. Google Scholar 3 : Systematic 5 region prostate biopsy is superior to sextant method for diagnosing carcinoma of the prostate. J Urol1997; 157: 199. Link, Google Scholar 4 : Optimizing performance and interpretation of prostate biopsy: a critical analysis of the literature. Eur Urol2010; 58: 851. Google Scholar 5 : Twelve prostate biopsies detect significant cancer volumes (>0.5 ml). BJU Int2000; 85: 705. Google Scholar 6 : Guidelines for processing and reporting of prostatic needle biopsies: Members of the Pathology Committee of the European Randomized Study of Screening for Prostate Cancer. J Clin Pathol2003; 56: 336. Google Scholar 7 : Handling and pathology reporting of prostate biopsies: European Society of Uropathology and European Society of Pathology Uropathology Working Group. Eur Urol2004; 46: 177. Google Scholar 8 : Needle core length is a quality indicator of systematic transperineal prostate biopsy. Eur Urol2006; 50: 266. Google Scholar 9 : Needle core length in sextant biopsy influences prostate cancer detection rate. Urology2002; 59: 698. Google Scholar 10 : Comparison of 3 different methods of anesthesia before transrectal prostate biopsy: a prospective randomized trial. J Urol2004; 172: 502. Link, Google Scholar 11 : The Vienna nomogram: validation of a novel biopsy strategy defining the optimal number of cores based on patient age and total prostate volume. J Urol2005; 174: 1256. Link, Google Scholar 12 : Can we obtain better specimens with an end-cutting prostatic biopsy device?. Eur Urol2005; 47: 297. Google Scholar 13 : Detection of prostate cancer: a comparative study of the diagnostic efficacy of sextant transrectal versus sextant transperineal biopsy. Urology2000; 56: 617. Google Scholar 14 : Best approach for prostate cancer detection: a prospective study on transperineal versus transrectal six-core prostate biopsy. Urology2003; 61: 961. Google Scholar © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 6June 2012Page: 2051-2055 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.Keywordsprostatic neoplasmsreference standardsdiagnosisprostatebiopsyAcknowledgmentsSakine Demir, Nuray Ağdaş, Aynur Kılıçkaya, Gülnur Öztürk Ayaz and Kadir Demirbaş assisted with biopsies.MetricsAuthor Information Can Öbek Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author Tünkut Doğanca Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author Sinan Erdal Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey Department of Public Health, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author Sarper Erdoğan Department of Urology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey Department of Public Health, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author Haydar Durak Department of Pathology, Cerrahpaşa School of Medicine, University of Istanbul, Istanbul, Turkey More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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• W1963652802 title "Core Length in Prostate Biopsy: Size Matters" @default.
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