title: Extended biopsy protocol decreases prostate cancer incidence and risk of aggressive disease on repeated biopsies compared with initial standard procedure.
abstract: OBJECTIVE
  To compare prostate cancer detection rates in repeated biopsy depending on the number of cores at initial biopsy.
  
  
  METHODS
  Out of 3,000 consecutive patients, 534 underwent repeat extended biopsies. At first procedure, 345 patients had undergone standard biopsies (10-15 cores; SBx) whereas 189 other patients had already had a 21-core extended protocol (ExtBx). Clinicobiological and pathological parameters were compared between 2 groups.
  
  
  RESULTS
  The prostate cancer detection rate was significantly higher in the SBx group (37%) compared with the ExtBx group (16.8%, p < 0.001). Mean PSA level, mean percent free PSA and mean prostate volume were equivalent in both groups. Thirty-eight percent of cancers detected in the SBx group were graded Gleason 7 or more, compared with 19.3% in the ExtBx group (p = 0.018). Mean percent of core invasion was 25.3% in the SBx group compared to 15.9% in the ExtBx group (p = 0.004).
  
  
  CONCLUSIONS
  A full evaluation of all prostate zones using ExtBx seems to be necessary to decrease the risk of undetected prostate cancer on repeated biopsies. For patients who had at their first biopsy an ExtBx, the risk of prostate cancer on the repeated biopsies and the risk of aggressive cancer were lower compared to standard biopsies.
authors.affiliation: INSERM U588 Eq07 Departments of Urology and Pathology, APHP, CHU Henri Mondor, Créteil, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Ploussard
authors.forename: Laurence
authors.initials: L
authors.lastname: Bastien
authors.forename: Aurélien
authors.initials: A
authors.lastname: Descazeaud
authors.forename: Grégoire
authors.initials: G
authors.lastname: Robert
authors.forename: Yves
authors.initials: Y
authors.lastname: Allory
authors.forename: Laurent
authors.initials: L
authors.lastname: Salomon
authors.forename: Dimitri
authors.initials: D
authors.lastname: Vordos
authors.forename: Andreas
authors.initials: A
authors.lastname: Hoznek
authors.forename: René
authors.initials: R
authors.lastname: Yiou
authors.forename: Claude-Clément
authors.initials: CC
authors.lastname: Abbou
authors.forename: Alexandre
authors.initials: A
authors.lastname: de la Taille
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D049109:Cell Proliferation; D006801:Humans; D015994:Incidence; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging / Q000379:methods; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D012306:Risk
chemical_list: D017430:Prostate-Specific Antigen