The role of extended prostate biopsy on prostate cancer detection rate: a study performed on the bench

ABSTRACT

INTRODUCTION: The aim of this prospective study was to compare the advantage of performing prostate biopsy with a greater number of cores using the classic sextant procedure, with the aim of reducing false negative results. MATERIALS AND METHODS: 100 prostates were acquired from consecutive radical prostatectomies performed by the same surgeon. Fourteen cores were obtained on the bench following surgery using an automatic pistol with an 18-gauge needle. Six of these cores were obtained according to the sextant technique, as described by Hodge et al.; with the addition of a further three lateral cores from each lobe and one from the bilateral transition zone. The whole gland and the fragments were assessed by the same pathologist. An analysis of the frequency of the cancers identified in the cores of the sextant and the extended biopsies was undertaken and the results evaluated comparatively. The chi-square test was used for the comparative analysis of the cancer detection rate, according to the technique used. RESULTS: When 6 cores were removed, the positive cancer rate was 75 percent, which was increased to 88 percent when 14 cores were (p < 0.001). The withdrawal of 14 cores resulted in a significant 13 percent (95 percent CI [5 percent-21 percent]) increase in the positive rate of cancer detection. CONCLUSION: Extended biopsy, with the removal of 14 cores, is more efficient than the sextant procedure in improving the rate of prostate cancer detection.