VALUE OF SYSTEMATIC TRANSITION ZONE BIOPSIES IN THE EARLY DETECTION OF PROSTATE-CANCER

Purpose: A prospective study was done to determine the value of perfor ming 2 systematic transition zone biopsies in addition to systematic s extant peripheral zone biopsies for early detection of prostate cancer . Materials and Methods: From January 1 to August 31, 1994 we evaluate d 847 consecutive patients referred to us for a suspicious lesion on d igital rectal examination or an elevated serum prostate specific antig en level. All patients underwent 2 systematic transition zone biopsies in addition to systematic sextant biopsies of the peripheral zone. Re sults: Of the transition zone biopsies 68 (24.4%) contained malignancy , including only 8 (2.9%) with cancer found exclusively in the transit ion zone. The remaining 271 cases (97.1%) had 1 or more positive perip heral zone biopsies and would have been detected with or without addit ional systematic transition zone biopsies. The same analysis of 552 pa tients with a negative digital rectal examination yielded 6 (4.1%) exc lusively transition zone tumors among 145 cancers detected in this gro up. Conclusions: The low additional yield of transition zone biopsies (2.9 to 4.1%) does not warrant their systematic use for the early dete ction of prostate cancer.