Extended sector biopsy for detection of carcinoma of the prostate

Purpose: To determine whether an extended sector biopsy of the prostate wil l increase the detection of prostate cancer. without causing an increase in morbidity. Materials and Methods: A total of 74 men with a mean age of 62. 3 years (46-98 years) who either had an elevated PSA or an abnormal digital rectal exam underwent a transrectal ultrasound guided needle biopsy. Begin ning on 7/1/98, an extended sector biopsy technique was performed on 74 pat ients by one urologist (RRB). Each transrectal ultrasound guided needle bio psy included 17 total cores (normal sextant biopsy. 2 in each peripheral zo ne, and 2 in the transition zone). We retrospectively reviewed the biopsy r esults for the location of cancer. PSA data and morbidity of the procedures were reviewed. Results: Of 74 total patients, 40 (54.1%) were positive for adenocarcinoma of the prostate. There were 10 positive results detected on ly in the additional zones. If one looks at the total number of cancers det ected (40). then 10/40 (25%) of the cancers detected were found in the addi tional regions only or in 13.5% of all patients biopsied. Of the 10 patient s with sector only prostate cancer. 8 were detected in the peripheral zone, 1 in the transition zone and 1 in both zones. All 10 patients had a Gleaso n pattern score 3+3=6 or 4+3 =7. There were no atypical or PIN cores found in the sector zones only. PSA ranged from 1.2-142 (median 6.0 ng/ml). The m edian PSA was 6.2 ng/ml in all patients found to have cancer, and 6.0 ng/ml in the cancers detected only in the additional zones. There was 1 (1.49 %) complication of urinary retention and fiver. Conclusion: Our study suggest s that an extensive sector biopsy may increase the detection of prostate ca ncer by 13.5% over a routine sextant biopsy without demonstrable serious mo rbidity. (C) 2001 Elsevier Science Inc. All rights reserved.