Objectives To compare, in a retrospective study, pathological specimens of
prostate cancer detected in additional areas of a 12-core biopsy with tumou
rs detected using traditional sextant biopsy.
Patients and methods The study included 27 patients who had undergone radic
al prostatectomy (RP) for prostate cancer. Prostatectomy specimens of cance
rs detected using standard sextant biopsies were compared with those detect
ed using six additional core biopsies. The RP specimens were analysed for c
ancer volume, Gleason score, tumour grade (Mostofi) and pathological stage.
Results Of the 27 patients, six (29%) had cancer detected in the extra six
biopsy cores which would have otherwise have been undetected using sextant
biopsy. Only two insignificant cancers were detected. The mean Gleason scor
e was 6.1 for cancer detected by the sextant or 12-core method (P = 0.907);
the mean grade (Mostofi) was 2.1 and 2.33, respectively (P = 0.29). The fi
nal tumour stage in the 21 patients undergoing sextant biopsy was pT2 in 13
and pT3 in eight, compared with six pT2 tumours in the six patients diagno
sed using extra biopsies. The mean (median, range) tumour volume was 5.7 (3
.5, 0.312-23.75) mL for cancers detected on sextant biopsy and 1.99 (1.85,
0.4-3.6) mL in the six cancers detected using extra cores (P = 0.0138).
Conclusion The detection of prostate cancer was increased using extra biops
y cores. There was a significant difference in tumour volume but not in Gle
ason score, Mostofi grade or final pathological tumour stage between tumour
s diagnosed using 12 cores and those detected on sextant biopsy.