Is systematic sextant biopsy suitable for the detection of clinically significant prostate cancer?

Background: The optimal extent of the prostate biopsy remains controversial . There is a need to avoid detection of insignificant cancer but not to mis s significant and curable tumors. In alternative treatments of prostate can cer, repeated sextant biopsies are used to estimate the response. The aim o f this study was to investigate the reliability of a repeated systematic se xtant biopsy as the standard biopsy technique in patients with significant tumors which are being considered for curative treatment. Methods: Systemat ic sextant biopsy was performed in vitro in 92 radical prostatectomy specim ens. Of these patients, 81 (88.0%) had palpable lesions. Results: Of the 92 investigated patients, 70 (76.1%) had potentially curable pT2-3pN0 prostat e cancers. In these patients, the cancer was detected only in 72.9% of case s by a repeated in vitro biopsy. In the pT2 tumors, there was a detection r ate of only 66.7%. Conclusions: This study underlines the fact that a consi derable number of significant and potentially curable tumors remain undetec ted by the conventional sextant biopsy. A negative sextant biopsy does not rule out significant prostate cancer. Copyright (C) 2000 S. Karger AG, Base l.