Value of systematic transition zone biopsies in the early detection of prostate cancer.
OBJECTIVE
A prospective study was done to determine the value of performing 2 systematic transition zone biopsies in addition to systematic sextant peripheral zone biopsies for early detection of prostate cancer.


METHODS
From January 1 to August 31, 1994 we evaluated 847 consecutive patients referred to us for a suspicious lesion on digital rectal examination or an elevated serum prostate specific antigen level. All patients underwent 2 systematic transition zone biopsies in addition to systematic sextant biopsies of the peripheral zone.


RESULTS
Of the transition zone biopsies 68 (24.4%) contained malignancy, including only 8 (2.9%) with cancer found exclusively in the transition zone. The remaining 271 cases (97.1%) had 1 or more positive peripheral zone biopsies and would have been detected with or without additional systematic transition zone biopsies. The same analysis of 552 patients with a negative digital rectal examination yielded 6 (4.1%) exclusively transition zone tumors among 145 cancers detected in this group.


CONCLUSIONS
The low additional yield of transition zone biopsies (2.9 to 4.1%) does not warrant their systematic use for the early detection of prostate cancer.
Bazinet
M
M
UROMED Prostate Cancer Detection Center, McGill University, Montreal, Quebec, Canada.
Karakiewicz
P I
PI
Aprikian
A G
AG
Trudel
C
C
Aronson
S
S
Nachabé
M
M
Péloquin
F
F
Dessureault
J
J
Goyal
M
M
Zheng
W
W
Bégin
L R
LR
Elhilali
M M
MM
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000473:pathology*; D013997:Time Factors
D017430:Prostate-Specific Antigen