A simple method for estimating the optimum number of prostate biopsy cores needed to maintain high cancer detection rates while minimizing unnecessary biopsy sampling.

Abstract:

OBJECTIVE:The objective was to provide urologists with a simple basis for optimizing the number of prostate biopsy cores that should be taken. METHODS:The records of 1024 patients who had undergone transrectal ultrasound-guided biopsies were reviewed. The prostate volume was divided by the number of biopsies to obtain the volume/biopsy ratio (VBR). Univariate and multivariate analyses were performed to determine the best predictors for positive biopsies. RESULTS:The analysis included 939 patients who had prostatic-specific antigen <20 ng/mL. The significant independent variables for positive biopsies were age, prostatic-specific antigen, and prostate volume and VBR (p < 0.001). VBR had the strongest correlation coefficient out of all significant variables. Stepwise analysis showed a consistent increase in cancer detection rates as VBR was decreased. The detection rates for VBRs of 2, 3, and 4 were 59%, 53%, and 50%, respectively. The detection rates dropped sharply to 42% and 30% for VBRs of 5 and 6, respectively. Cancers diagnosed with low VBRs were similar to those diagnosed with high VBRs in regard to Gleason scores and percentages of cancer in the prostatectomy specimens. CONCLUSION:Using VBR of 4 maintains high cancer detection rates without taking an excessive number of biopsy specimens. This is a simple and easy-to-remember method.

journal_name

J Endourol

journal_title

Journal of endourology

authors

Jiang J,Colli J,El-Galley R

doi

10.1089/end.2009.0285

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

143-7

issue

1

eissn

0892-7790

issn

1557-900X

journal_volume

24

pub_type

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