OUTCOME OF SEXTANT BIOPSY ACCORDING TO GLAND VOLUME

Objectives. To reassess positive rate of sextant biopsy according to g land size. Methods. We evaluated 1974 consecutive men with systematic sextant biopsy, among whom we examined biopsy yield according to gland -volume intervals of 10 cc.Results. Decreasing yield of sextant biopsy is strongly associated with increasing gland volume (P <0.001). Highe st biopsy rate (39.6%) was recorded among men with prostates smaller t han 20 cc. The lowest biopsy rate (10.1%) was recorded among men with prostates between 80 and 89.9 cc. Among men with biopsy-proven cancer, age, serum prostate-specific antigen, and Gleason grade were comparab le (P >0.05) throughout the range of gland-volume intervals. Conclusio ns. Our findings suggest that gland size represents an important deter minant contributing to the yield of sextant biopsy in men at risk of h arboring a nonpalpable, isoechoic cancer. Consequently, an individuali zed sector biopsy approach, based on prostate volume, may warrant cons ideration because it may ensure superior detection of clinically signi ficant disease among all-men at risk, regardless of prostate size. Cop yright 1997 by Elsevier Science Inc.