EFFICACY OF TRANSRECTAL ULTRASOUND-GUIDED SEMINAL-VESICLE BIOPSIES INTHE DETECTION OF SEMINAL-VESICLE INVASION BY PROSTATE-CANCER

Detection of microscopic seminal vesicle invasion with prostate cancer by transrectal ultrasound-guided seminal vesicle biopsies provides a method of evaluation that is much less subjective than digital rectal examination or imaging techniques. The accuracy of seminal vesicle bio psy is analyzed in 73 patients undergoing transrectal ultrasound-guide d biopsy of 145 seminal vesicles followed by radical prostatectomy. Of 133 benign seminal vesicle biopsies 11 (8.3%) were found in the surgi cal specimen to have cancer involving an average of 6% of the seminal vesicle area. Of 8 seminal vesicle biopsies showing cancer adjacent to seminal vesicle epithelium 100% demonstrated seminal vesicle invasion in the surgical specimen extending for an average of 19% of the semin al vesicle area. Three biopsies exhibited cancer but no seminal vesicl e epithelium; only 1 (33%) of these had seminal vesicle invasion for 5 % of the seminal vesicle area. One biopsy revealed normal prostate tis sue. Careful placement of bilateral biopsy sites cephalad to the prost ate base (not traversing any portion of the prostate gland) is recomme nded. Caution should be exercised when basing treatment decisions on s eminal vesicle biopsies that do not reveal seminal vesicle epithelium histologically.