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• W2052079328 abstract "No AccessJournal of UrologyAdult Urology: Oncology: Prostate/Testis/Penis/Urethra1 May 2005INDIVIDUALIZATION OF THE BIOPSY PROTOCOL ACCORDING TO THE PROSTATE GLAND VOLUME FOR PROSTATE CANCER DETECTION SAADETTIN YILMAZ ESKICORAPCI, FUAD GULIYEV, BULENT AKDOGAN, HASAN SERKAN DOGAN, ALI ERGEN, and HALUK OZEN SAADETTIN YILMAZ ESKICORAPCISAADETTIN YILMAZ ESKICORAPCI More articles by this author , FUAD GULIYEVFUAD GULIYEV More articles by this author , BULENT AKDOGANBULENT AKDOGAN More articles by this author , HASAN SERKAN DOGANHASAN SERKAN DOGAN More articles by this author , ALI ERGENALI ERGEN More articles by this author , and HALUK OZENHALUK OZEN More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000154242.60413.3dAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: In this study we assessed the relative yield of 10 core biopsy, and the whole range of alternative 8 and 6 core biopsy protocols over that of the classic sextant biopsy protocol. We determined the optimum number of cores per biopsy according to prostate volume in patients who experienced prostate biopsy for the first time. Materials and Methods: A total of 503 men with the indications of abnormal digital rectal examination and/or serum prostate specific antigen greater than 2.5 ng/ml were included in the study. All patients underwent a 10 core biopsy protocol with an additional 1 core from each suspicious area detected by transrectal ultrasound. Prostate volume was divided into quartiles, namely 14.9 to 35, 35.1 to 50, 50.1 to 65 and 65.1 to 150 cc. The optimum number of biopsy cores was determined in patients with different prostate volumes. Results: Median age was 63 years and prostate specific antigen was 7.4 ng/ml in the whole group. Of 503 patients 159 (31.6%) were positive for prostate cancer. Cancer detection rates decreased significantly from 49.6% to 20.8% as prostate volume increased in preset quartiles. Lesion biopsies revealed the lowest unique cancer detection rates for all prostate volume quartiles (0% to 3%). There was an obvious positive trend in cancer detection rates in favor of the 10 core biopsy protocol over sextant biopsies in all patient groups. Classic sextant biopsy protocol proved to be inadequate for all prostate volumes. Among sextant biopsy protocols laterally placed cores including the apex, lateral mid gland and lateral base had the best cancer detection rates (81% to 95%). The 8 core biopsy scheme consisting of the apex, mid gland, lateral mid gland and lateral base resulted in an only 1% lower detection rate (97%) than the 10 core biopsy protocol in the lowest quartile. The yield of the 10 core biopsy protocol in patients with a prostate volume of between 35.1 and 150 cc outscored that of the optimal 8 core biopsy scheme including the apex, base, lateral mid gland and lateral base with 3% to 8% differences in the cancer detection rate. Conclusions: The 10 core biopsy protocol must be used in all group of patients except patients with a prostate volume of 14.9 to 35 cc. In patients with a prostate volume of 14.9 to 35 cc the 8 core biopsy protocol consisting of the apex, mid gland, lateral mid gland and lateral base can be used since it revealed results similar to those of the 10 core biopsy protocol. The classic sextant biopsy protocol seemed inadequate for all prostate volumes. Patients with a larger prostate had lower cancer detection rates. Transrectal ultrasound directed lesion biopsies may be omitted when using 10 core biopsy protocols since the yield of these biopsies was less than 2%. References 1 : Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol1989; 142: 71. Abstract, Google Scholar 2 : The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer. Urology1997; 50: 562. 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Link, Google Scholar 10 : A model for the number of cores per prostate biopsy based on patient age and prostate gland volume. J Urol1998; 159: 920. Link, Google Scholar 11 : Three-dimensional computer-simulated prostate models: lateral prostate biopsies increase the detection rate of prostate cancer. Urology1999; 53: 961. Google Scholar 12 : Twelve systematic prostate biopsies are superior to sextant biopsies for diagnosing carcinoma: a prospective randomized study. Br J Urol1997; 80: 239. Google Scholar 13 : Results of the 5 region prostate biopsy method: the repeat biopsy population. J Urol2002; 168: 500. Link, Google Scholar 14 : Preoperative serum prostate specific antigen levels between 2 and 22 ng./ml. correlate poorly with post-radical prostatectomy cancer morphology: prostate specific antigen cure rates appear constant between 2 and 9 ng./ml. J Urol2002; 167: 103. Link, Google Scholar 15 : Serum prostate-specific antigen as a predictor of prostate volume in men with benign prostatic hyperplasia. Urology1999; 53: 581. Google Scholar 16 : Examination of the 3 molecular forms of serum prostate specific antigen for distinguishing negative from positive biopsy: relationship to transition zone volume. J Urol2000; 163: 119. Link, Google Scholar 17 : The relationship of prostate gland volume to extended needle biopsy on prostate cancer detection. J Urol2003; 169: 130. Link, Google Scholar 18 : Prostate biopsy: how many cores are enough?. Urol Oncol2003; 21: 135. Google Scholar 19 : Contemporary update of prostate cancer staging nomograms (Partin Tables) for the new millennium. Urology2001; 58: 843. Google Scholar 20 : Validation of 2001 Partin tables in Turkey: a multicenter study. Eur Urol2005; 47: 185. Google Scholar From the Department of Urology, Hacettepe University, School of Medicine, Ankara, Turkey© 2005 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byHambrock T, Somford D, Hoeks C, Bouwense S, Huisman H, Yakar D, van Oort I, Witjes J, Fütterer J and Barentsz J (2018) Magnetic Resonance Imaging Guided Prostate Biopsy in Men With Repeat Negative Biopsies and Increased Prostate Specific AntigenJournal of Urology, VOL. 183, NO. 2, (520-528), Online publication date: 1-Feb-2010.Neill M, Toi A, Lockwood G, Evans A, Tammsalu L and Fleshner N (2018) Systematic Lateral Prostate Biopsy—Are the Benefits Worth the Costs?Journal of Urology, VOL. 179, NO. 4, (1321-1326), Online publication date: 1-Apr-2008.Serfling R, Shulman M, Thompson G, Xiao Z, Benaim E, Roehrborn C and Rittmaster R (2018) Quantifying the Impact of Prostate Volumes, Number of Biopsy Cores and 5α-Reductase Inhibitor Therapy on the Probability of Prostate Cancer Detection Using Mathematical ModelingJournal of Urology, VOL. 177, NO. 6, (2352-2356), Online publication date: 1-Jun-2007.Eskicorapci S and Tuncay L (2018) Re: Diagnostic Value of Systematic Biopsy Methods in the Investigation of Prostate Cancer: A Systematic ReviewJournal of Urology, VOL. 176, NO. 6, (2745-2746), Online publication date: 1-Dec-2006. Volume 173Issue 5May 2005Page: 1536-1540 Advertisement Copyright & Permissions© 2005 by American Urological Association, Inc.Keywordsprostatic neoplasmsbiopsyultrasound, high-intensity focused, transrectalprostateMetricsAuthor Information SAADETTIN YILMAZ ESKICORAPCI More articles by this author FUAD GULIYEV More articles by this author BULENT AKDOGAN More articles by this author HASAN SERKAN DOGAN More articles by this author ALI ERGEN More articles by this author HALUK OZEN More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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