A Comparative Analysis of Sextant and an Extended 11-Core Multisite Directed Biopsy Strategy

Abstract

Biopsies of the alternate sites suggested by our simulation studies are feasible and reproducible. This new strategy significantly enhanced (p = 0.0075) prostate cancer detection compared to conventional sextant biopsies in men undergoing a repeat procedure.

Spatial Distribution of Prostate Cancers Undetected on Initial Needle Biopsies

“…Due to improved biopsy techniques, the detection rate of early prostate cancers has increased. Recent modifications include different strategies to cover all regions of the prostate with at least 8 systematic biopsies [4, 5]. Performed by an experienced urologist, this diagnostic procedure is now highly reliable.…”

“…We suppose that some of the carcinomas in the study group represent clinically significant carcinomas in an earlier stage of development. In a recent study, Babaian et al [5]showed a remarkable increase in cancer detection in rebiopsies of the lateral portion of the inferior anterior horn of the peripheral zone, which is mainly situated in the apico–dorsal parts of our 64 prostatic compartments. In another recent investigation, Presti et al [4]stressed the fact that the majority of cancers usually arise in the peripheral zone.…”

“…High serum PSA levels, in combination with or without abnormal transrectal ultrasound or abnormal digital rectal examination should lead to a prostate biopsy. Different biopsy techniques have been developed: digitally guided biopsy, biopsy of hypoechoic prostate lesions, four–quadrant biopsy, transrectal ultrasound–guided systematic sextant and octant prostate biopsy, and others have been applied to increase cancer detection rate [2, 3, 4, 5]. Nevertheless, a negative systematic prostate biopsy does not exclude clinically significant cancer.…”

Transrectal Ultrasound in the Diagnosis of Prostate Cancer: State of the Art and Perspectives

“…3D ultrasonography of the prostate seems to be of additional value for volume measurement of the prostate [36, 37, 38], taking transrectally directed prostate biopsy specimens [39, 40], staging of prostate cancer [41, 42], and follow–up of therapy of prostate cancer [43, 44, 45]. Most authors conclude that 3D ultrasound certainly has potential to be of additional value in certain investigations of the prostate.…”

The ProtecT trial - Evaluating the effectiveness of treatment for clinically localised prostate cancer

“…• TRUS-guided biopsy (10 cores) [21][22][23] under antibiotic prophylaxis according to local protocols…”