Abstract
Objectives
To evaluate the diagnostic performance of 14-core repeat biopsy protocol and the impact of prior biopsy scheme on repeat prostate biopsy group.
Methods
211 patients had repeat biopsy using 14-core protocol consisting of 10-core peripheral zone (classical sextant+4 lateral peripheral cores) and 4-core transitional zone (TZ) biopsies. The diagnostic yield was determined both in patients who had previously undergone sextant or 10-core biopsy protocol.
Results
Overall cancer detection rate was 25.6%. 14-core biopsy technique detected cancer in 36.1 and 18.7% of the patients who had a previous sextant biopsy and 10-core biopsy protocol, respectively (P = 0.005). Patients with and without high-grade prostatic intraepithelial neoplasia (HGPIN) in the previous sextant biopsy had 56.5 and 28.3% cancer detection rates on the subsequent extended biopsy, respectively (P = 0.017) Patients who had previous 10-core biopsy with and without HGPIN revealed 22.9 and 17.2% cancer detection rates, respectively (P = 0.465) Additional four lateral peripheral cores detected 33% (3/30) and 17% (4/24) of cancers in patients with previous sextant and 10-core biopsy, respectively. 3.7% of the patients had tumor only in the TZ and none of them had prior extended biopsy.
Conclusions
The yield of extended 14-core repeat biopsy protocol was higher in patients with previous negative sextant biopsy compared to the patients with previous negative 10-core biopsy. HGPIN history found on previous sextant biopsy was a strong cancer predictor on repeat biopsy; same was not true for the patients with previous 10-core biopsy. The yield of lateral peripheral cores and TZ biopsies were lower in patients with prior negative extended biopsy.
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References
Hodge KK, McNeal JE, Terris MK, Stamey TA (1989) Random systematic versus directed ultrasound guided transrectal core biopsies of the prostate. J Urol 142:71–74
Rabbani F, Stroumbakis N, Kava BR, Cookson M, Fair WR (1998) Incidence and clinical significance of false-negative sextant prostate biopsies. J Urol 159:1247–1251
Presti JC Jr (2003) Prostate biopsy: how many cores are enough? Urol Oncol 21(2):135–143
Eskew LA, Bare RL, McCullough DL (1997) Systematic 5 region prostate biopsy is superior to sextant method diagnosing carcinoma of the prostate. J Urol 157:199–202
Eskicorapci SY, Baydar DE, Akbal C, Sofikerim M, Günay M, Ekici S, Ozen H (2004) An extended 10-core transrectal ultrasonography-guided prostate biopsy protocol improves the detection of prostate cancer. Eur Urol 45(4):444–448
Eskicorapci SY, Guliyev F, Akdogan B, Dogan HS, Ergen A, Ozen H (2005) Individualization of the biopsy protocol according to the prostate gland volume for prostate cancer detection. J Urol 173:1536–1539
Djavan B, Ravery V, Zlotta A, Dobronski P, Dobrovits M, Fakhari M et al (2001) Prospective evaluation of prostate cancer detected on biopsies 1, 2, 3 and 4: When should we stop? J Urol 166:1679–1684
Borboroglu PG, Comer SW, Riffenburgh RH, Amling CL (2000) Extensive repeat transrectal ultrasound guided prostate biopsy in patients with previous benign sextant biopsies. J Urol 163:158–161
Stewart CS, Leibovich BC, Weaver AL, Lieber MM (2001) Prostate cancer diagnosis using a saturation needle biopsy technique after previous negative sextant biopsies. J Urol 166:86–90
Carter HB, Epstein JI, Chan DW, Fozard JL, Pearson JD (1997) Recommended prostate-specific antigen testing intervals for the detection of curable prostate cancer. JAMA 277:1456
Hong YM, Lai FC, Chon CH, McNeal JE, Presti JC Jr (2004) Impact on prior biopsy scheme on pathological features of cancers detected on repeat biopsies. Urol Oncol 22:7–11
Chon CH, Lai FC, McNeal JE, Presti JC (2002) Use of extended systematic sampling in patients with a prior negative prostate needle biopsy. J Urol 167:2457–2461
Babaian RJ, Toi A, Kamoi K, Troncoso P, Sweet J, Evans R et al (2000) A comparative analysis of sextant and an extended 11-core multisite directed biopsy strategy. J Urol 163:152–156
Applewhite JC, Matlaga BR, McCullough DL (2002) Results of the 5 region prostate biopsy method: the repeat biopsy population. J Urol 168:500–504
Eskicorapci SY, Karabulut E, Türkeri L, Baltaci S, Cal C, Toktas G et al (2005) Validation of 2001 Partin tables in Turkey: a multicenter study. Eur Urol 47:185–188
Herawi M, Kahane H, Cavallo C, Epstein JI (2006) Risk of prostate cancer on first re-biopsy within 1 year following a diagnosis of high grade prostatic intraepithelial neoplasia is related to the number of cores sampled. J Urol 175:121–124
Lopez-Corona E, Ohori M, Scardino PT, Reuter VE, Gonen M, Kattan MW (2003) A nomogram for predicting a positive repeat prostate biopsy in patients with a previous negative biopsy session. J Urol 170:1184–1189
Keetch DW, Catalona WJ (1995) Prostatic transition zone biopsies in men with previous negative biopsies and persistently elevated serum prostate specific antigen values. J Urol 154:1795–1799
Lui PD, Terris MK, McNeal JE, Stamey TA (1995) Indications for ultrasound guided transition zone biopsies in the detection of prostate cancer. J Urol 153:1000–1005
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Take home messages: The 14-core repeat biopsy protocol was superior in patients with previous negative sextant biopsy. HGPIN history on previous sextant biopsy was a strong cancer predictor. Yield of lateral peripheral and TZ biopsies were lower in patients with prior extended biopsy.
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Eskicorapci, S.Y., Guliyev, F., Islamoglu, E. et al. The Effect of Prior Biopsy Scheme on Prostate Cancer Detection for Repeat Biopsy Population: Results of the 14-core Prostate Biopsy Technique. Int Urol Nephrol 39, 189–195 (2007). https://doi.org/10.1007/s11255-006-9009-5
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DOI: https://doi.org/10.1007/s11255-006-9009-5