title: The effect of prior biopsy scheme on prostate cancer detection for repeat biopsy population: results of the 14-core prostate biopsy technique.
abstract: OBJECTIVE
  To evaluate the diagnostic performance of 14-core repeat biopsy protocol and the impact of prior biopsy scheme on repeat prostate biopsy group.
  
  
  METHODS
  211 patients had repeat biopsy using 14-core protocol consisting of 10-core peripheral zone (classical sextant+4 lateral peripheral cores) and 4-core transitional zone (TZ) biopsies. The diagnostic yield was determined both in patients who had previously undergone sextant or 10-core biopsy protocol.
  
  
  RESULTS
  Overall cancer detection rate was 25.6%. 14-core biopsy technique detected cancer in 36.1 and 18.7% of the patients who had a previous sextant biopsy and 10-core biopsy protocol, respectively (P = 0.005). Patients with and without high-grade prostatic intraepithelial neoplasia (HGPIN) in the previous sextant biopsy had 56.5 and 28.3% cancer detection rates on the subsequent extended biopsy, respectively (P = 0.017) Patients who had previous 10-core biopsy with and without HGPIN revealed 22.9 and 17.2% cancer detection rates, respectively (P = 0.465) Additional four lateral peripheral cores detected 33% (3/30) and 17% (4/24) of cancers in patients with previous sextant and 10-core biopsy, respectively. 3.7% of the patients had tumor only in the TZ and none of them had prior extended biopsy.
  
  
  CONCLUSIONS
  The yield of extended 14-core repeat biopsy protocol was higher in patients with previous negative sextant biopsy compared to the patients with previous negative 10-core biopsy. HGPIN history found on previous sextant biopsy was a strong cancer predictor on repeat biopsy; same was not true for the patients with previous 10-core biopsy. The yield of lateral peripheral cores and TZ biopsies were lower in patients with prior negative extended biopsy.
authors.affiliation: Department of Urology, School of Medicine, Hacettepe University, Ankara, Turkey. drsye@yahoo.com
authors.forename: Saadettin Yilmaz
authors.initials: SY
authors.lastname: Eskicorapci
authors.forename: Fuad
authors.initials: F
authors.lastname: Guliyev
authors.forename: Ekrem
authors.initials: E
authors.lastname: Islamoglu
authors.forename: Ali
authors.initials: A
authors.lastname: Ergen
authors.forename: Haluk
authors.initials: H
authors.lastname: Ozen
mesh_terms: D000368:Aged; D001706:Biopsy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D019048:Prostatic Intraepithelial Neoplasia; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000473:pathology*; D012307:Risk Factors