Transition zone biopsy in the detection of prostate cancer

Objective: About 25% of all prostate cancers occur in the transition zone ( TZ). We analyzed the impact of 4 systematic TZ and 2 systematic apex (AP) b iopsies in addition to systematic sextant biopsies in an effort to establis h the diagnostic importance of early prostate cancer. Methods: One hundred and thirty patients underwent systematic transperineal multipoint prostate biopsy (biopsy of 12 sites, including 4 TZ and 2 AP bi opsies). Results: Forty-one of 130 men (31.5%) had biopsy specimens positive for can cer, and cancer originated in the TZ alone in 4 of these 41 patients (9.8%) . Fourteen patients underwent radical retropubic prostatectomy. We compare the pathological findings of radical prostatectomy specimens and biopsy res ults. Prostate cancers predicted to be stage T-2c by TZ biopsy were all cla ssified as pT(2c) or greater. Conclusions: Routine TZ biopsy does not substantially increase the prostate cancer detection rate; however, it can be useful in patients who require r epeat biopsy. Copyright (C) 2000 S. Karger AG, Basel.