Original Article Optimization of prostate cancer diagnosis by increasing the number of core biopsies based on gland volume

Received July 16, 2012; Accepted September 3, 2012; Epub October 20, 2012; Published October 30, 2012Abstract: In this prospective, non-randomized phase-I clinical trial, we comparatively studied the performance of six laterally-directed biopsies or the modified fan-shaped biopsies (MFSB), midline sextant biopsies (MB), and transi-tion zone biopsies (TZB) and examine their prostate cancer (PCa) detection rates. A total of 114 patients received combinations of MFSB, MB, and TZB based on prostate gland volume: those ≤15cc received 8 biopsies; those >15cc but ≤ 50cc received 14 biopsies; and those >50cc received 20 biopsies. The mean prostate-specific antigen (PSA) level, Gleason score, and prostate volume were 8.0 ng/ml, 6.4, and 47 cc, respectively. PCa detection rate of the MB was 25% while the MFSB was 22%. The overall PCa detection rate was 33.3% with all biopsies. PCa and high-grade prostatic intraepithelial neoplasia (HG-PIN) detection rates decrease as the size of the prostate in-creases. PCa detection rates were 50.0% for volumes ≤19.9cc and volumes of >50cc had a detection rate of 25.8%. PSA levels of 9.0. In a multivariate analysis, only TZB was significant for PCa diagnosed by PSA (β=7.4, p 15 cc but ≤50 cc, and 14-20 for those >50 cc.Keywords: Prostate cancer, prostate gland volume, transrectal core biopsies, gleason score, PSA