Elsevier

Urology

Volume 49, Issue 3, Supplement 1, March 1997, Pages 113-118
Urology

CME article
Clinical significance of repeat sextant biopsies in prostate cancer patients**

https://doi.org/10.1016/S0090-4295(97)00178-7Get rights and content

Abstract

Objectives

Six random systematic core biopsies (SRSCB) of the prostate is considered by many to represent the standard method of detecting prostate cancer. We sought to evaluate the sensitivity of the transrectal ultrasound (TRU)S-guided needle biopsies in 89 consecutive patients with a history of biopsy-proven prostate cancer. These patients underwent repeat biopsy prior to enrollment in an ongoing, randomized protocol. We also compared the clinical and pathological features of patients with SRSCB-documented prostate carcinoma and negative repeat-sextant biopsy.

Methods

Our study population consisted of 89 patients enrolled in our randomized, prospective study assessing the effect of androgen deprivation therapy in combination with radical prostatectomy for clinically localized prostate cancer. A comparison was made of the patients' rebiopsy results with initial biopsy. Patients having either a positive or negative rebiopsy were analyzed with respect to grade, T stage, prostate-specific antigen (PSA), PSA density (PSAD), organ-confined rate, and final surgical margin status.

Results

Repeat sextant biopsy was positive for prostate cancer in 71 (80%) patients and negative in 18 (20%) patients. There was no significant difference between patients with a negative or positive rebiopsy with respect to PSA or PSAD. There was a trend toward greater prostate volumes in the negative-rebiopsy group (P = 0.08) and lower clinical stage in the negative rebiopsy (P = 0.025) group. In patients with a negative repeat biopsy, the organ-confined (OC) rate was 77% (14/18 patients), as compared to the positiverebiopsy group of 56% (40/71 patients) (P = 0.08). Similarly, the margin-positive rate in the negative-rebiopsy group was 17% (3/18 patients), as compared to the positive-rebiopsy group who had a marginpositive rate of 44% (31/71 patients) (P = 0.03).

Conclusions

In patients with clinically localized disease, the sensitivity of SRSCB in detecting carcinoma is 80%. The results of this study highlight the potential sampling error of the SRSCB and the implication of a negative rebiopsy in patients with clinically significant prostate cancer.

References (24)

Cited by (108)

  • The role of pathology correlation approach in prostate cancer index lesion detection and quantitative analysis with multiparametric MRI

    2015, Academic Radiology
    Citation Excerpt :

    It is possible for such samples to be marked as to their location within the gland, thus facilitating spatial correlation with the imaging based on the prostate zonal anatomy (36). However, consistency of the tissue core labeling differs across the institutions, and sampling error can be quite large: up to 46% of patients can have false-negative results on repeat sextant biopsy (37–39). In conclusion, WMP is necessary to accurately localize all PCa index lesions.

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**

This work was supported by National Institutes of Health grant ROI CA 57458-04 and the Tow Family Foundation.

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