Comparison of 6- and 12-core prostate biopsy in Taiwanese men: impact of total prostate-specific antigen, prostate-specific antigen density and prostate volume on prostate cancer detection.
BACKGROUND
We retrospectively compared 6- and 12-core prostate biopsies in Taiwanese men and evaluated the impact of prostate volume (PV), prostate-specific antigen (PSA), and PSA density (PSAD) on the prostate cancer detection rate (PCDR).


METHODS
1,086 consecutive patients with a total PSA of 4.1-20.0 ng/ml and/or abnormal digital rectal examination undergoing first-time transrectal ultrasound-guided biopsy were included. Group I patients (n = 562) underwent sextant biopsy and group II patients (n = 524) underwent sextant biopsy with an extra three lateral cores on both sides. The patients were further stratified into subgroups according to PV (cut-off: 35 ml), PSA (cut-off: 10.0 ng/ml), and PSAD (cut-off: 0.2).


RESULTS
Prostate cancer was diagnosed in 228/1,086 (21.0%) patients. The PCDR was higher in group II (23.7%) than group I (18.5%). 12-Core biopsy yielded a significantly higher PCDR than 6-core biopsies in patients with PV >35 ml, PSA 4.1-10.0 ng/ml, PSAD <or=0.20, but not in patients with PV <or=35 ml, PSA 10.1-20.0 ng/ml, PSAD >0.20.


CONCLUSIONS
12-Core biopsy yielded a significantly higher PCDR in Taiwanese men with a total PSA of 4.1-20.0 ng/ml, especially in patients with PSA 4.1-10.0 ng/ml, PSAD <or=0.20, and PV >35 ml.
Chiang
I-Ni
IN
Department of Urology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chang
Shang-Jen
SJ
Pu
Yeong-Shiau
YS
Huang
Kuo-How
KH
Yu
Hong-Jen
HJ
Huang
Chao-Yaun
CY
D000368:Aged; D001707:Biopsy, Needle / Q000009:adverse effects; D051517:Digital Rectal Examination; D006801:Humans; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000276:immunology / Q000473:pathology; D012372:ROC Curve; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013624:Taiwan; D018084:Ultrasonography, Interventional
D017430:Prostate-Specific Antigen