Reassessing the diagnostic yield of saturation biopsy of the prostate.
OBJECTIVE
Prostate biopsy remains the gold standard for detection of prostate cancer (PCa). This study was performed to determine whether saturation biopsy (>or= 24 cores) detects more prostate cancer than a standard 12-18 core office biopsy technique.


METHODS
We conducted a nonrandomized cohort study of a consecutive series of prostate biopsies. The primary outcome assessed by both univariate and multivariate analysis was the detection of PCa, whereas the secondary outcomes of HGPIN (high-grade prostatic intraepithelial neoplasia) and ASAP (atypical small acinar proliferation) were also analyzed.


RESULTS
From September 2005 to June 2006, a total of 469 patients undergoing prostate biopsy were included in this study. A standard office prostate biopsy was performed in 301 men, whereas 168 underwent a saturation biopsy. Age, body mass index (BMI), prostate volume, and family history of PCa were similar. However, patients in the saturation biopsy cohort were more likely to have had prior biopsies, higher prebiopsy PSA, longer PSA doubling times, and to carry more frequent diagnoses of HGPIN or ASAP (all p<0.05). After adjusting for covariates, saturation biopsy did not detect more abnormal pathology than standard office prostate biopsy, including PCa (OR, 1.2; p=0.339), HGPIN (OR, 1.4; p=0.368), or ASAP (OR, 2.2; p=0.201).


CONCLUSIONS
Saturation biopsy does not appear to detect more abnormal prostate pathology than standard office biopsy of the prostate. This procedure may be associated with increased cost and patient morbidity.
Ashley
Richard A
RA
Department of Urology, Mayo Clinic, Rochester, MN, USA.
Inman
Brant A
BA
Routh
Jonathan C
JC
Mynderse
Lance A
LA
Gettman
Matthew T
MT
Blute
Michael L
ML
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis*; D000368:Aged; D001706:Biopsy / Q000379:methods*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis*; D015203:Reproducibility of Results
D017430:Prostate-Specific Antigen