Peripheral 10 Sites Prostate Biopsy: Is It Really Effective?

Yeo, Byong Gu; Lee, Eun Sik; Byun, Seok Soo

Abstract

PURPOSE: This study was designed to evaluate the effectiveness of the transrectal ultrasound (TRUS) guided prostatic peripheral 10-sites biopsy method for the diagnosis of prostatic cancer.
MATERIALS AND METHODS
TRUS guided biopsy of peripheral 10-sites, including routine sextant and 4 far lateral regions (lateral mid-lobes and bases), was performed in 78 patients with suspicious prostatic cancer. The patients were categorized into 2 groups; the benign disease group and the prostatic cancer group, according to the pathologic results. Various parameters were compared between the 2 groups.
RESULTS
Prostatic cancer was detected in 32 patients (41%). The median age and PSA of the prostatic cancer group, 70.5 years and 25ng/ml, respectively, were significantly higher than those of the benign disease group, 63.5 years and 9.7ng/ml, respectively (p<0.05). The average Gleason scores and number of cancer positive biopsies of the prostatic cancer group were 7.3 (4-10) and 4.5 (1-10), respectively. A far lateral region only tumor was discovered in 1 (3.1%) of the 32 patients. The cancer detection rate increased with increasing PSA level (p<0.05). Patients with a prostate volume of less than 50cc showed significantly higher cancer detection rates than those with a prostate volume of more than 50cc (p<0.05). Fifty-four patients (69%) experienced complications and 4, with symptomatic urinary tract infection, recovered uneventfully with the application of parenteral antibiotics on admission.
CONCLUSIONS
There was a 3.1% increase in the cancer detection rate with the use of a peripheral 10-sites biopsy compared to the sextant method. The use of additional biopsies, including those of the far lateral apex region, with the 10-sites biopsy method is suggested would increase detection rates.