title: Saturation biopsy technique increase the capacity to diagnose adenocarcinoma of prostate in patients with PSA < 10 ng/ml, after a first negative biopsy.
abstract: OBJECTIVE
  Aim of this study was to evaluate if saturation biopsy (SB) technique increases the cancer detection rate in patients with PSA < 10 ng/ml, after a first negative biopsy.
  
  
  METHODS
  From January 2004 to January 2006, 780 patients underwent prostate ultrasound guided transrectal (UGT) core biopsy: 186 (23.8%) presented prostate cancer (PCa) while 594 pts (76.2%), were disease free. For 1 year all the patients with no evidence of cancer were observed according to a follow-up schedule including PSA every 3 months and DRE every 6 months. During this period 140 patients showed an increase of PSA (< 10 ng/ml) or a low PSA free/total. This group underwent a second prostate UGT core biopsy with SB technique. In all the patients we evaluated PCa detection rates (DR) according to the PSA range. We also checked peri/post-operative complication rate (total post-operative hospitalization time, haemoglobin loss, catheterisation rate, pain rate, QOL).
  
  
  RESULTS
  Of the 140 patients 50 (35.7%) had PCa showing a Gleason score (GS) of 4 or 5 in 26%, 6 or 7 in 75% and 8 to 10 in 9% respectively. Sectors apical biopsies carried out in the anterior horn of peripheral zone tissue presented over 70% (35 patients) of cancer detection rate. Rectal bleeding was the major common complication. Cancer was clinically significant in 47 patients (94%) but 34 (68%) presented an organ confined disease after radical surgery.
  
  
  CONCLUSIONS
  SB technique increases of 35.7% the cancer detection rate (DR) in patients with PSA < 10 ng/ml, after a first negative biopsy, showing a higher positivity (70% PCaDR) if the SB included the anterior horn of peripheral zone tissue. No significantly pain and side effects were observed.
authors.affiliation: Division of Urology, Villa Tiberia Clinic, Rome, Italy. roberto.giulianelli@virgilio.it
authors.forename: Roberto
authors.initials: R
authors.lastname: Giulianelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Brunori
authors.forename: Barbara Cristina
authors.initials: BC
authors.lastname: Gentile
authors.forename: Giorgio
authors.initials: G
authors.lastname: Vincenti
authors.forename: Stefano
authors.initials: S
authors.lastname: Nardoni
authors.forename: Francesco
authors.initials: F
authors.lastname: Pisanti
authors.forename: Teuta
authors.initials: T
authors.lastname: Shestani
authors.forename: Luca
authors.initials: L
authors.lastname: Mavilla
authors.forename: Luca
authors.initials: L
authors.lastname: Albanesi
authors.forename: Francesco
authors.initials: F
authors.lastname: Attisani
authors.forename: Gabriella
authors.initials: G
authors.lastname: Mirabile
authors.forename: Manlio
authors.initials: M
authors.lastname: Schettini
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood; D001706:Biopsy / Q000379:methods; D001707:Biopsy, Needle; D004867:Equipment Design; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D011237:Predictive Value of Tests; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016896:Treatment Outcome; D018084:Ultrasonography, Interventional
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen