Effects of sextant transrectal prostate biopsy plus additional far lateral cores in improving cancer detection rates in men with large prostate glands.
OBJECTIVE
To determine whether additional, far lateral cores improve the diagnostic performance of transrectal sextant biopsy in men with large prostate glands.


METHODS
Men with prostate volumes of 50 mL or greater in transrectal ultrasonography who were suspected of prostatic adenocarcinoma were prospectively enrolled. Biopsy criteria were defined as 2.0 ng/mL or greater of serum total prostate-specific antigen and/or abnormal findings on digital rectal examination. Four cores of far lateral biopsies were added to the standard sextant technique.


RESULTS
Of 104 patients enrolled in the present study and undergoing biopsy, 14 (13.5%) were diagnosed as having prostate cancer and 27 (26.0%) were diagnosed as having prostatic intraepithelial neoplasia (PIN) or an atypical gland. There were no cases where cancer was only detected in the additional cores, whereas PIN/atypical gland was uniquely detected from the additional, far lateral sites in eight of the 27 patients who were diagnosed with this condition.


CONCLUSIONS
Although the number of patients diagnosed as having PIN/atypical gland might increase with the addition of far lateral cores, this additional sampling does not improve cancer detection rates in men with large prostate glands.
Kobayashi
Takashi
T
Department of Urology, Hamamatsu Rosai Hospital, Hamamatsu, Japan.
Nishizawa
Koji
K
Watanabe
Jun
J
Ogura
Keiji
K
Mitsumori
Kenji
K
Ide
Yoshihiro
Y
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis*; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000000981:diagnostic imaging* / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011470:Prostatic Hyperplasia / Q000000981:diagnostic imaging; D019048:Prostatic Intraepithelial Neoplasia / Q000097:blood / Q000175:diagnosis; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D014463:Ultrasonography
D017430:Prostate-Specific Antigen