Optimal site and number of biopsy cores according to prostate volume prostate cancer detection in Korea.
OBJECTIVE
To compare different biopsy schemes for detecting prostate cancer in Korean men.


METHODS
A total of 516 men, 40 to 79 years old (mean 64.1 +/- 7.8), constituted the study cohort. The patients were divided to quartiles according to prostate volume: 10 to 30, 30.1 to 40, 40.1 to 55, and 55.1 to 162 cm3.


RESULTS
The cancer detection rates decreased as the prostate volume increased in the quartiles used (P = 0.001). The group-specific cancer detection rate was 20.0% to 23.8%, 22.1% to 25.6%, 23.6% to 26.6%, and 27.7% in the 6, 8, 10, and 12-core groups, respectively. In all patients undergoing sextant biopsy, laterally placed cores, including the apex, lateral mid-gland, and lateral base, seemed as optimal as the six-core biopsy scheme. The unique cancer detection rates of each biopsy region were low in all patients groups and were not significantly different according to prostate volume quartile. Of the patients with suspicious lesions on transrectal ultrasonography, no cancer was present only in the lesion-directed biopsies, even if sextant biopsy technique was used.


CONCLUSIONS
Our data have shown that lower core schemes can be used with results almost similar to those using the 12-core protocol in this population. A laterally placed, six-core technique is an appropriate biopsy scheme in patients with a prostate volume of less than 40 cm3. Transrectal ultrasound-directed biopsies can be omitted even when using six-core biopsy protocols because the yield of these biopsies was low. Prebiopsy transrectal ultrasonography is unnecessary because the prostate volume estimation can be done at the same time as the biopsy.
Shim
Hong Bang
HB
Department of Urology, Seoul Veterans Hospital, Seoul, Korea.
Park
Hyoung Keun
HK
Lee
Sang Eun
SE
Ku
Ja Hyeon
JH
D000328:Adult; D000367:Age Factors; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D015331:Cohort Studies; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000000981:diagnostic imaging* / Q000401:mortality / Q000473:pathology*; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D047368:Tumor Burden; D014463:Ultrasonography; D036761:Ultrasound, High-Intensity Focused, Transrectal
D017430:Prostate-Specific Antigen