title: Does transrectal ultrasound guided eight-core prostate biopsy improve cancer detection rates in patients with prostate-specific antigen levels of 4.1-10 ng/mL?
abstract: BACKGROUND
  To investigate retrospectively whether the eight-core biopsy method improves the prostate cancer detection rate when compared with the standard sextant biopsy method in patients with prostate specific antigen (PSA) levels of 4.1-10 ng/mL.
  
  
  METHODS
  Of 437 patients whose PSA levels ranged from 4.1 to 10 ng/mL, 237 underwent a transrectal ultrasound guided sextant biopsy (sextant group), and 200 underwent an eight-core biopsy (eight-core group). Eight core samples were obtained from each of the far lateral regions in addition to the standard sextant biopsy cores. None of the patients had a previous history of prostate biopsy.
  
  
  RESULTS
  Of the 237 patients in the sextant group, prostate cancer was detected in 47 patients (19.8%) and in 50 of the 200 patients in the eight- core group (25.0%). The rates of detection in the two methods were not statistically significant. However, in patients whose PSA density was less than 0.1 ng/mL per cc, the cancer detection rates in the sextant group and the eight-core group were 4.5% and 18.8%, respectively (P = 0.046). The morbidity and complications of the eight-core biopsy method were not notable.
  
  
  CONCLUSIONS
  Only in patients with PSA levels of 4.1-10 ng/mL and density of less than 0.1 ng/mL per cc was the eight-core biopsy method an improvement on the sextant biopsy method in terms of prostate cancer detection rate. Accordingly, a number of cores greater than eight will be required to improve the cancer detection rates in patients with PSA levels of 4.1-10 ng/mL and PSA densities of more than 0.1 ng/mL per cc.
authors.affiliation: Department of Urology, Chiba Cancer Center, Chiba, Japan. yshinya@chiba-cc.jp
authors.forename: Shinya
authors.initials: S
authors.lastname: Yamamoto
authors.forename: Takaaki
authors.initials: T
authors.lastname: Ito
authors.forename: Taku
authors.initials: T
authors.lastname: Aizawa
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Noda
authors.forename: Kiyokazu
authors.initials: K
authors.lastname: Umezu
authors.forename: Norihiko
authors.initials: N
authors.lastname: Ohtsuru
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hata
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D012189:Retrospective Studies; D014463:Ultrasonography
chemical_list: D017430:Prostate-Specific Antigen