Prostate saturation biopsy following a first negative biopsy: state of the art.
BACKGROUND
Saturation prostate biopsy (SPBx) has been initially introduced to improve prostate cancer (PCa) detection rate (DR) in the repeat setting. Nevertheless, the optimal number and the most appropriate location of the cores, together with the timing to perform a second PBx and the eventual modification of the PBx protocols according to the different clinical situations, are matters of debate. The aim of this review is to perform a critical analysis of the literature about the actual role of SPBx in the repeat setting.


METHODS
We performed a systematic review of the literature since 1995 up to 2011. Electronic searches were limited to the English language, using the MEDLINE database. The key words 'saturation prostate biopsy' and 'repeated prostate biopsy' were used.


RESULTS
SPBx improves PCa DR if clinical suspicion persists after previous biopsy with negative findings and provides an accurate prediction of prostate tumor volume and grade, even if the issue about the number and locations of the cores is still a matter of debate.


CONCLUSIONS
At present, SPBx seems to be really necessary in men with persistent suspicion of PCa after negative initial biopsy and probably in patients with a multifocal high-grade prostatic intraepithelial neoplasia or atypical small acinar proliferation. In the remaining situations, adopting an individualized scheme is preferable.
Department of Urology, San Raffaele Scientific Institute, Milan, Italy. carmen.maccagnano @ gmail.com
Carmen
C
Maccagnano
Andrea
A
Gallina
Marco
M
Roscigno
Marco
M
Raber
Umberto
U
Capitanio
Antonino
A
Saccà
Federico
F
Pellucchi
Nazareno
N
Suardi
Firas
F
Abdollah
Francesco
F
Montorsi
Patrizio
P
Rigatti
Vincenzo
V
Scattoni
D001706:Biopsy / Q000379:methods*; D055088:Early Detection of Cancer / Q000379:methods; D006801:Humans; D008297:Male; D008495:Medical Oncology / Q000379:methods; D011467:Prostate / Q000473:pathology* / Q000503:physiopathology; D017430:Prostate-Specific Antigen / Q000378:metabolism; D019048:Prostatic Intraepithelial Neoplasia / Q000473:pathology; D011471:Prostatic Neoplasms / Q000175:diagnosis*; D015203:Reproducibility of Results; D014572:Urology / Q000379:methods
D017430:Prostate-Specific Antigen