Prostate cancer distribution in patients diagnosed by transperineal template-guided saturation biopsy.
OBJECTIVE
To determine the prostate cancer incidence, anatomic distribution, Gleason score profile, and tumor burden in patients diagnosed by transperineal template-guided saturation biopsy (TTSB).


METHODS
One hundred and two patients underwent TTSB; all but one patient had undergone at least one prior negative TRUS biopsy. Criteria for inclusion included an elevated PSA and/or the diagnosis of ASAP or high-grade PIN on prior biopsy. The prostate gland was divided into 24 regional biopsy locations. The median number of biopsy cores was 50. Multiple clinical parameters were evaluated as predictors for prostate cancer diagnosis.


RESULTS
The mean patient age was 64.8 yr with a mean PSA of 9.1 ng/ml and a prostate volume of 78.6 cm(3). On average, patients had undergone 2.1 prior negative TRUS biopsies with a mean of 22.4 core biopsies. Prostate cancer was diagnosed in 43 patients (42.2%) with a Gleason score distribution of 6-9. No anatomic region of the prostate gland was spared of cancer. In patients with prostate cancer, an average of 9.9 cores were involved. In multivariate analysis, prostate volume was the best predictor for prostate cancer diagnosis.


CONCLUSIONS
TTBS diagnosed prostate cancer in 42.2% of patients. Considerable anatomic variability in prostate cancer distribution was documented. On the basis of this and other reports, cancer eradication will depend on treatment of the entire prostate gland.
Merrick
Gregory S
GS
Schiffler Cancer Center, Wheeling Hospital and Wheeling Jesuit University, Wheeling, WV 26003-6300, USA. gmerrick@urologicresearchinstitute.org
Gutman
Sarah
S
Andreini
Hugo
H
Taubenslag
Walter
W
Lindert
David L
DL
Curtis
Rodney
R
Adamovich
Edward
E
Anderson
Richard
R
Allen
Zachariah
Z
Butler
Wayne
W
Wallner
Kent
K
D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy / Q000379:methods*; D018267:Carcinoma, Acinar Cell / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging / Q000379:methods; D010502:Perineum; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000453:epidemiology* / Q000473:pathology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen