Retrospective study comparing six- and twelve-core prostate biopsy in detection of prostate cancer.
OBJECTIVE
We compared the safety and efficacy of the 12-core biopsy with those of the conventional systematic 6-core biopsy with PSA levels between 4.1 and 20.0 ng/mL.


METHODS
This study included 428 patients who underwent a 6-core biopsy and 128 patients who underwent a 12-core biopsy. Biopsies were performed transrectally under ultrasound guidance. The 12-core biopsy scheme involved obtaining 6 far lateral cores.


RESULTS
For patients with PSA level between 4.1 and 10.1 ng/mL, 47 of the 265 patients who underwent 6-core biopsy and 32 of the 91 patients who underwent a12-core biopsy were diagnosed with prostate cancer (p = 0.0006). Among the patients with a PSA level between 10.1 and 20.0 ng/mL, 48 of 163 patients who underwent the 6-core biopsy and 16 of 37 patients who underwent the 12-core biopsy were diagnosed with prostate cancer (p = 0.0606). Three of the 95 patients who were diagnosed with prostate cancer through the 6-core biopsy and 12 of the 48 patients who were diagnosed through the 12-core biopsy had cancer located in the anterior apex. The 12-core biopsy increased the diagnostic rate in the apex (p = 0.001). No statistically significant differences were found in incidence of complications.


CONCLUSIONS
We concluded that the 12-core biopsy is a safe and more effective procedure for increasing the diagnostic rate of prostate cancer than the 6-core biopsy in patients with PSA level between 4.1 and 10.0 ng/mL, and the most useful anatomical area to be added was found to be cores from the anterior apex.
Tobiume
Motoi
M
Department of Urology, Aichi Medical University, School of Medicine, Nagakute, Aichi, Japan.
Yamada
Yoshiaki
Y
Nakamura
Kogenta
K
Honda
Nobuaki
N
D000368:Aged; D001707:Biopsy, Needle / Q000379:methods* / Q000592:standards; D051517:Digital Rectal Examination / Q000379:methods; D006801:Humans; D008297:Male; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000032:analysis; D011471:Prostatic Neoplasms / Q000473:pathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D017430:Prostate-Specific Antigen