A COMPARATIVE ANALYSIS OF SEXTANT AND AN EXTENDED 11-CORE MULTISITE DIRECTED BIOPSY STRATEGY
2000; Lippincott Williams & Wilkins; Volume: 163; Issue: 1 Linguagem: Inglês
10.1016/s0022-5347(05)67993-1
ISSN1527-3792
AutoresR. Joseph Babaian, Ants Toi, Kazumi Kamoi, Patricia Troncoso, Joan Sweet, Robert B. Evans, Dennis A. Johnston, Michael Chen,
Tópico(s)Colorectal Cancer Screening and Detection
ResumoNo AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2000A COMPARATIVE ANALYSIS OF SEXTANT AND AN EXTENDED 11-CORE MULTISITE DIRECTED BIOPSY STRATEGY R. JOSEPH BABAIAN, ANTS TOI, KAZUMI KAMOI, PATRICIA TRONCOSO, JOAN SWEET, ROBERT EVANS, DENNIS JOHNSTON, and MICHAEL CHEN R. JOSEPH BABAIANR. JOSEPH BABAIAN More articles by this author , ANTS TOIANTS TOI More articles by this author , KAZUMI KAMOIKAZUMI KAMOI More articles by this author , PATRICIA TRONCOSOPATRICIA TRONCOSO More articles by this author , JOAN SWEETJOAN SWEET More articles by this author , ROBERT EVANSROBERT EVANS More articles by this author , DENNIS JOHNSTONDENNIS JOHNSTON More articles by this author , and MICHAEL CHENMICHAEL CHEN More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)67993-1AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The 3 tumor locations unsampled by conventional sextant biopsies that have been identified on composite 3-dimensional reconstruction of 180 radical prostatectomy specimens are the anterior transition zone, midline peripheral zone and inferior portions of the anterior horn in the peripheral zone. We evaluated an 11-core multisite directed biopsy scheme incorporating these alternate areas and conventional sextant biopsies in 362 patients from 2 institutions. Materials and Methods: Patients without a prior diagnosis of cancer underwent ultrasound guided 11-core biopsies which included conventional sextant and 3 alternate sites. All specimens were separated for specific location identification. Biopsy was performed in 183 patients at MD Anderson Cancer Center (group 1) and in 179 at Toronto General Hospital (group 2). All group 2 and 54% of group 1 patients (98 of 183) had a prior biopsy negative for cancer. Results: Median prostate specific antigen was higher in group 2 than in group 1 patients (11.5 versus 9.5 ng./ml., p = 0.016). Overall a 33% increase (36 of 110 patients) in cancer detection was observed when biopsy technique included the alternate areas (p = 0.0021). The anterior horn was the most frequently positive biopsy site followed by the transition zone and midline sites. The 11-core technique had significantly better cancer detection rates when digital rectal examination and transrectal ultrasound were normal, and in men with serum prostate specific antigen between 4.1 and 10 ng./ml. Conclusions: Biopsies of the alternate sites suggested by our simulation studies are feasible and reproducible. This new strategy significantly enhanced (p = 0.0075) prostate cancer detection compared to conventional sextant biopsies in men undergoing a repeat procedure. References 1 : The fall in incidence of prostate carcinoma. On the down side of a prostate specific antigen induced peak in incidence—data from the Utah Cancer Registry. Cancer1996; 77: 1342. Google Scholar 2 : Cancer statistics 1999. CA Cancer J Clin1999; 49: 8. Google Scholar 3 : Measurement of prostate-specific antigen in serum as a screening test for prostate cancer. 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Volume 163Issue 1January 2000Page: 152-157 Advertisement Copyright & Permissions© 2000 by American Urological Association, Inc.Keywordsprostatic neoplasmsprostatectomybiopsyMetrics Author Information R. JOSEPH BABAIAN More articles by this author ANTS TOI More articles by this author KAZUMI KAMOI More articles by this author PATRICIA TRONCOSO More articles by this author JOAN SWEET More articles by this author ROBERT EVANS More articles by this author DENNIS JOHNSTON More articles by this author MICHAEL CHEN More articles by this author Expand All Advertisement PDF downloadLoading ...
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