Extensive Biopsy Protocol Improves the Detection Rate of Prostate Cancer

Ravery, V.; Goldblatt, Laurent; Royer, B.; Blanc, Emmanuel; Toublanc, M.; Boccon-Gibod, L

doi:10.1097/00005392-200008000-00029

Cited by 33 publications

(41 citation statements)

References 12 publications

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“…However, the present detection rate of an additional 6% of tumours con®ned exclusively to the lateral PZ compares favourably with Ravery et al [23], who noted a 6.6% overall improvement in prostate cancer detection with the addition of 4 ±6 lateral PZ biopsies, depending on prostate volume. In contrast, Naughton et al [24] found no signi®cant improvement (27% vs 26%) in cancer detection when a 12-core extended biopsy protocol incorporating the lateral PZ was prospectively compared with routine sextant biopsies alone.…”

Section: Discussionsupporting

confidence: 78%

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Durkan¹,

Sheikh²,

Johnson³

et al. 2002

BJU Int

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Objective To investigate whether taking two transition zone (TZ) and four lateral peripheral zone (PZ) biopsies in addition to routine parasaggital sextant biopsies would improve detection rates in men with suspected prostate cancer. Patients and methods The study included 493 consecutive men (mean age 68.7 years, SD 8.2) with elevated serum prostate-speci®c antigen (PSA) levels and/or abnormal ®ndings on a digital rectal examination who underwent transrectal ultrasonography-guided prostate biopsy. In addition to sextant biopsies, six further biopsies were obtained, two from the TZ (mid-gland) and four from the lateral PZ (base and mid-gland).Pathological ®ndings for the additional biopsies were compared with those of the sextant regions. Results Prostatic adenocarcinoma was diagnosed in 164 of the 493 (33%) men biopsied. Men with cancer were older, had smaller prostates and higher median PSA levels than men with negative biopsies. Sextant biopsies were positive for cancer in 133 of 164 (81%) men. All three sets of biopsies were positive in 53 (32%) cases. In 50 (30%) men both the sextant and lateral PZ biopsies were positive, while in six (4%) men, both sextant and TZ biopsies were positive. Thirty-one (19%) tumours were not detected by sextant biopsies, 10 (6%) where the lateral PZ biopsies alone were positive, 17 (10%) where the TZ biopsies alone were positive and four (3%) where both the TZ and lateral PZ together were positive. There were no differences in median PSA concentration, total prostate volume or TZ volume between men with an isolated TZ cancer and men with cancer elsewhere in the prostate. However, 77% of men with TZ cancer had a PSA of >10 ng/mL, compared with 60% of men with cancer at other sites within the prostate (P=0.015). Conclusion An extended-core biopsy protocol signi®cantly improves the detection rate for prostate cancer when compared with the standard sextant biopsy protocol alone. Routine TZ biopsies should be considered for men with serum PSA levels of >10 ng/mL.

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Section: Discussionsupporting

confidence: 78%

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Durkan¹,

Sheikh²,

Johnson³

et al. 2002

BJU Int

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“…[6][7][8][9] A review of recent MEDLINE English literature studies that report on complications of transrectal prostate biopsies and list hematochezia as a complication, showed that of 5911 men biopsied only four required admission for observation of hematochezia, three had oversewing of the rectal mucosa within 2 h of the biopsy to stop bleeding and none required transfusion (Table 1). [10][11][12][13][14][15][16][17] This man had an arterial bleeder that opened 5 days after his biopsy; poorly controlled hypertension and the firm bowel movement most likely contributed to the life-threatening hemorrhage. Neovascularization related to his large volume of disease with high Gleason-grade carcinoma may also have contributed to this patient's excessive bleeding.…”

Section: Discussionmentioning

confidence: 99%

Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Petroski

Griewe

Schenkman

2003

Prostate Cancer Prostatic Dis

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“…[4][5][6][7] Kelly et al 7 reported a sensitivity for TRUS and CDU, respectively, of 96 and 87%, with only one out of 158 cases of adenocarcinoma not visible with a standard TRUS. Newman et al 8 reported a sensitivity and specificity for malignancies of 49 and 93% emphasizing the necessity of a biopsy, even in patients with a negative CDU.…”

Section: Discussionmentioning

confidence: 99%

“…We performed the extended biopsy scheme of Ravery et al: 5 three cores in each lobe (base, median portion and apex), three cores on the left and right lateral margin of the gland and two additional cores on the transition zone. In the areas where a marked increase in vascularization after the Levovist s injection was visible, further bioptic samples were taken.…”

Section: Methodsmentioning

confidence: 99%

Does the adjunct of ecographic contrast medium Levovist® improve the detection rate of prostate cancer?

Pepe

Patanè

Panella

et al. 2003

Prostate Cancer Prostatic Dis

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Objectives: To evaluate whether the adjunct of an ultrasound contrast medium improves the detection rate of prostate cancer. Method: In 34 patients, scheduled to undergo a trans-perineal extended prostate biopsy, we carried out a color-Doppler ultrasound (CDU) of the prostate before and after i.v. injection of Levovist s , an ultrasound contrast medium. Further bioptic samples were taken in the areas where a marked increase in vascularization was noticed. Results: The overall diagnostic sensitivity, specificity and efficiency were respectively 72.7, 56.2 and 62.9% for transrectal ultrasound (TRUS); 80, 56.2 and 65.3% for CDU and 88.8, 54.5 and 68% for CDU after Levovist s injection; 66.5, 72.6 and 65.1% for digito-rectal examination (DRE); 100, 51.4 and 65.4% for total PSA; and 100, 88.8 and 94.3% for PSA free/total. In the 16 patients with prostate carcinoma, the sensitivity of CDU after Levovist s was 92.3, 66% for both DRE and TRUS, and 80% for DRE plus TRUS. Conclusions: Considering the cost and the results obtained (high sensitivity and low specificity), a routine use of Levovist s does not seem indicated in patients undergoing prostatic biopsy. An exception may be represented by patients with both negative DRE and TRUS.

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Extensive Biopsy Protocol Improves the Detection Rate of Prostate Cancer

Abstract: Increasing the number of biopsy cores and improving prostate peripheral zone sampling resulted in a significant improvement in the detection of prostate cancer.

Cited by 33 publications

References 12 publications

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Improving prostate cancer detection with an extended-core transrectal ultrasonography-guided prostate biopsy protocol

Delayed life-threatening hemorrhage after transrectal prostate needle biopsy

Does the adjunct of ecographic contrast medium Levovist® improve the detection rate of prostate cancer?

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