Skip to main content
Log in

Six-core versus twelve-core prostate biopsy: a retrospective study comparing accuracy, oncological outcomes and safety

  • Original Article
  • Published:
Irish Journal of Medical Science (1971 -) Aims and scope Submit manuscript

Abstract

Aims

To compare sextant and 12 core transrectal ultrasound-guided (TRUS) prostate biopsies for detecting prostate cancer (PCa) and to determine whether 12-core prostate biopsies are associated with a higher incidence of insignificant prostate cancer and complications.

Methods

A retrospective study was performed on all patients with a positive TRUS biopsy for prostate cancer between January 2011 and December 2013. Group A underwent a sextant core prostate biopsy and group B underwent a 12-core prostate biopsy. Outcome variables were cancer detection rates, oncological outcomes, incidence of clinically insignificant PCa and incidence of biopsy associated complications. Exclusion criteria included a negative TRUS biopsy and metastatic prostate cancer.

Result

In total 718 prostate biopsies were performed and 286 patients met inclusion criteria (143 patients in each group). The overall cancer detection rate was 43 % in group A compared to 53 % in group B (p = 0.03). In group A, 31 (21.7 %) patients proceeded to open retropubic radical prostatectomy (RRP) compared to 36 (25.2 %) in group B (p = 0.7). Sextant biopsies were associated with a significantly higher rate of upgrading compared to 12-core biopsies in RRP specimens (51.6 versus 25 % respectively, p < 0.01). The incidence of clinically insignificant PCa was 10.5 % in group A versus 14.7 % in group B (p = 0.2). The incidence of urosepsis post biopsy was 0.7 % in both groups (n = 1).

Conclusion

Twelve-core biopsies were associated with higher PCa cancer detection rates, greater accuracy for Gleason grading and no differences for detecting clinically insignificant PCa or urosepsis compared to sextant biopsies.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Ferlay J, Autier P, Boniol M et al (2007) Estimates of the cancer incidence and mortality in Europe in 2006. Ann Oncol 18:581–592

    Article  PubMed  CAS  Google Scholar 

  2. Crawford ED, Hirano D, Werahera PN et al (1998) Computer modeling of prostate biopsy: tumor size and location–not clinical significance–determine cancer detection. J Urol 159:1260

    Article  PubMed  CAS  Google Scholar 

  3. http://www.cancer.ie/cancer-information/prostate-cancer/symptoms-and-diagnosis#sthash.lrjO5zGN.dpbs. Accessed January 2015

  4. Durkan GC, Sheikh N, Johnson P et al (2002) Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol. BJU Int 89(1):33–39

    Article  PubMed  CAS  Google Scholar 

  5. Ceylan C, Doluoglu OG, Aglamis E et al (2014) Comparison of 8, 10, 12, 16, 20 cores prostate biopsies in the determination of prostate cancer and the importance of prostate volume. Can Urol Assoc J 1–2:E81–E85

    Google Scholar 

  6. Rodrigues LV, Terris MK (1998) Risks and complications of transrectal ultrasound guided prostate needle biopsy: a prospective study and review of the literature. J Urol 160(6):2115–2120

    Article  Google Scholar 

  7. Ploussard G, Epstein JI, Montironi R et al (2011) The contemporary concept of significant versus insignificant prostate cancer. Eur Urol 60:291–303

    Article  PubMed  Google Scholar 

  8. Nakanishi H, Wang X, Ochiai A et al (2007) A nomogram for predicting low-volume/low-grade prostate cancer: a tool in selecting patients for active surveillance. Cancer 110(11):2441–2447

    Article  PubMed  Google Scholar 

  9. Heidenreich A, Bastian PJ, Bellmunt J et al (2014) EAU guidelines on prostate cancer. Part 1: screening, diagnosis, and local treatment with curative intent-update 2013. Eur Urol 65(1):124–137

    Article  PubMed  Google Scholar 

  10. Ignacio F, William CD, Seymour R et al (2003) Extended prostate needle biopsy improves concordance of Gleason grading between prostate needle biopsy and radical prostatectomy. J Urol 169:136–140

    Article  Google Scholar 

  11. Elabbady AA, Khedr MM (2006) Extended 12-core prostate biopsy increase both the detection of prostate cancer and the accuracy of gleason score. Eur Urol 49:49–53

    Article  PubMed  Google Scholar 

  12. Naughton CK, Miller DC, Mager DE et al (2000) A prospective randomised trial comparing 6 versus 12 prostate biopsy cores: impact on cancer detection. J Urol 164:388–392

    Article  PubMed  CAS  Google Scholar 

  13. Kim JW, Lee HY, Hong SJ et al (2004) Can a 12 core prostate biopsy increase the detection rate of prostate cancer versus 6 core? A prospective randomized study in Korea. Yonsei Med J 45(4):671–675

    Article  PubMed  Google Scholar 

  14. Epstein JI, Chan DW, Sokoll LJ et al (1998) Nonpalpable stage T1c prostate cancer: prediction of insignificant disease using free/total prostate specific antigen levels and needle biopsy findings. J Urol 2(160):2407

    Google Scholar 

  15. Tobiume M, Yamada Y, Nakamura K et al (2008) Retrospective study comparing six- and twelve-core prostate biopsy in detection of prostate cancer. Int Braz J Urol 34(1):9–14

    Article  PubMed  Google Scholar 

  16. Pinkstaff DM, Igel TC, Petrou SP et al (2005) Systematic transperineal ultrasound-guided template biopsy of the prostate: 3-year experience. Urology 65(4):735–739

    Article  PubMed  Google Scholar 

  17. Takenaka A, Hara R, Ishimura T et al (2008) A prospective randomized comparison of diagnostic efficacy between transperineal and transrectal 12-core prostate biopsy. Prostate Cancer Prostatic Dis 11(2):134–138

    Article  PubMed  CAS  Google Scholar 

  18. Hoeks CM, Schouten MG, Bomers JG et al (2012) Three-Tesla magnetic resonance-guided prostate biopsy in men with increased prostate-specific antigen and repeated, negative, random, systematic, transrectal ultrasound biopsies: detection of clinically significant prostate cancers. Eur Urol 62(5):902–909

    Article  PubMed  Google Scholar 

  19. Pinto PA, Chung PH, Rastinehad AR (2011) Magnetic resonance imaging/ultrasound fusion guided prostate biopsy improves cancer detection following transrectal ultrasound biopsy and correlates with multiparametric magnetic resonance imaging. J Urol 186(4):1281–1285

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Conflict of interest

Dr. Davis has nothing to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P. Sweeney.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mohammed, W., Davis, N.F., Elamin, S. et al. Six-core versus twelve-core prostate biopsy: a retrospective study comparing accuracy, oncological outcomes and safety. Ir J Med Sci 185, 219–223 (2016). https://doi.org/10.1007/s11845-015-1275-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11845-015-1275-8

Keywords

Navigation