Sampling, submission, and report format for multiple prostate biopsies: A 1999 survey

Objectives. Much variation occurs in sampling, submission, and reporting of prostate biopsies. Current practice standards among physicians across the United States are uncertain. Methods. We surveyed predominantly nonacademic urologists and pathologists. The response rate was 57 (21%) of 271 urologists and 47 (55%) of 85 pathol ogists, Results. Fifty-five percent of urologists performed six (or more) site-desi gnated biopsies; 41% used unspecified bilateral biopsies. More than one hal f of urologists and pathologists reported submitting or receiving six or mo re separate, site-designated containers, The remainder of physicians (less than one half) reported the submission of all left needle cores in one cont ainer and all right cores in the other. Most pathologists (70%) stated that billing depended on the number of containers; 15% were unsure. One hundred percent of academic and 68% of nonacademic urologists deemed the report fo rmat therapeutically relevant (P <0.03), as did 57% of pathologists. Physic ians submitting or receiving sextant needle biopsies in separate containers shared a 3:1 preference for issuance of a separate line diagnosis for each sextant site instead of condensing all diagnoses into one line with one Gl eason score. Similarly, for each biopsy site, 61% of urologists wanted a se parate Gleason score, and 68% wanted a separate designation for the percent age of tissue with tumor. Fifty-six percent and 64% of urologists and patho logists, respectively, deemed it relevant to specify the site(s) of high-gr ade prostatic intraepithelial neoplasia, even if cancer were present. Conclusions. Much variation persists in prostate biopsy sampling and report ing, hindering communication among physicians from different institutions. However, similar percentages of urologists and pathologists reported separa te versus combined site sampling and separate versus combined site report f ormat preferences. UROLOGY 55: 568-571, 2000. (C) 2000, Elsevier Science In c.