[Is sextant biopsy a valid method in diagnosis of prostatic cancer?].
We evaluated effectiveness of a laterally directed sextant biopsy on large prostates and analysed the results of this biopsy technique in a group of men with obstructive voiding symptoms and suspected prostatic cancer (PC). Biopsy was performed in 386 men because of elevated PSA and/or abnormality in digital rectal examinations (DRE). The mean prostate volume was 79.6 +/- 39.1 cm3, and in 72.3% of the cases the volume of the prostate was > or = 50 cm3. PC was diagnosed in 107 of 386 cases (27.7%). In groups of patients with < 50 cm3 (small), 50 to 79 cm3 (medium) and > or = 80 cm3 (large) prostate volume and normal DRE, PC was detected in 27.5, 19.4 and 9.5% of cases, respectively (p < 0.018). PC detection rate was statistically insignificant (SI) in the same groups of patients with abnormal findings at DRE, 49.2, 54.2 and 51.9%, respectively (SI). Repeat sextant biopsy revealed PC in 14.5% patients. After TURP prostatic cancer was found in 7.7% patients who had undergone biopsy two times before. Thus, our results show that laterally directed sextant biopsy is an effective method of PC detection among suspected patients (PSA > 4 ng/ml) with large volume prostates and abnormal findings at DRE. An extensive biopsy protocol should be considered as a more appropriate method for markedly enlarged prostates with normal DRE findings but also for repeat biopsies.
Kiknavelidze
K G
KG
Chanturaia
Z M
ZM
Silagava
D D
DD
Nikoleishvili
D O
DO
Tsintsadze
O V
OV
Managadze
L G
LG
D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011467:Prostate / Q000000981:diagnostic imaging / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology*; D020728:Transurethral Resection of Prostate; D014463:Ultrasonography; D014555:Urination Disorders / Q000209:etiology
D017430:Prostate-Specific Antigen