title: Improved detection of clinically significant, curable prostate cancer with systematic 12-core biopsy.
abstract: OBJECTIVE
  While systematic 12-core (S12C) biopsy detects more cancers than sextant biopsy, to our knowledge the clinical significance of these additionally detected tumors has not been established. We studied pathological parameters of prostatectomy specimens from patients undergoing radical prostatectomy for prostate cancer detected with a S12C biopsy to determine the clinical significance of these cancers in comparison with sextant detected cancers.
  
  
  METHODS
  A total of 179 consecutive patients undergoing radical prostatectomy for clinically localized prostate cancer detected by S12C biopsy were studied. The groups compared consisted of the sextant core subset of the S12C and the entire S12C set. Total tumor volume, Gleason score, organ confined status, surgical margin status, seminal vesicle invasion, lymph node involvement, and clinical significance of tumors detected by sextant and by S12C templates were compared.
  
  
  RESULTS
  S12C biopsy detected a greater number of cancers scored as moderate (Gleason score 2 to 6) or high (Gleason score 7 or greater) grade, and cancers of all sizes regardless of organ confined status than the sextant cores alone (all p <0.05). S12C biopsy identified a greater number of biologically significant and insignificant tumors regardless of how they were defined.
  
  
  CONCLUSIONS
  Compared with the sextant set S12C biopsy detects a significantly greater number of surgically curable, biologically significant tumors as well as those that might be considered clinically insignificant.
authors.affiliation: Department of Urology, Baylor College of Medicine, Houston, TX 77030, USA.
authors.forename: Herb
authors.initials: H
authors.lastname: Singh
authors.forename: Eduardo I
authors.initials: EI
authors.lastname: Canto
authors.forename: Shahrokh F
authors.initials: SF
authors.lastname: Shariat
authors.forename: Dov
authors.initials: D
authors.lastname: Kadmon
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Miles
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Wheeler
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Slawin
mesh_terms: D000368:Aged; D001707:Biopsy, Needle / Q000379:methods* / Q000592:standards; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000473:pathology*