The Efficacy of Prostate Biopsy by Use of the Vienna Nomogram

ABSTRACT

PURPOSE: No standard number of cores is obtained with a prostate needle biopsy. Routinely, we obtain 10 core biopsies but do not consider prostate volume or patient age. Consequently, we evaluated the clinical efficacy of prostate biopsy when taking into account prostate volume and patient age by use of the Vienna nomogram to suggest the proper number of cores. MATERIALS AND METHODS: Transrectal ultrasonography (TRUS)-guided prostate needle biopsies were performed in 326 patients between November 2006 and June 2009. Group A (10 cores biopsy) was 131 patients. Group B (biopsy using Vienna nomogram) was 134 patients. We compared the cancer detection rate between the two groups, especially according to age and prostate volume. The chi-squared test was used for statistical analysis. RESULTS: The overall cancer detection rates in groups A and B were 33.6% and 32.1%, respectively. In older patients (age> or =60 years), group B had a higher detection rate than did group A (37.0% vs. 35.6%). For patients with a small prostate (<30 g), group B had a significantly higher detection rate than did group A (62.1% vs. 30.4%, p=0.023). CONCLUSIONS: There was no significant difference in the overall cancer detection rate. However, in patients with a small prostate and in older patients, the Vienna nomogram was more effective than a 10-core biopsy. The Vienna nomogram could help to establish guidelines for prostate biopsy in Korea that take into account the prostate volume and the age of the patient. It could also help urologists to reduce unnecessary cores when diagnosing prostate cancer in the elderly population and in those with small prostates.