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Hasan Dogan. Haluk ÖZEN. Bulent Akdogan. Prostata-Volumenrate cc determined the optimum number of cores per biopsy according to prostate volume in patients who experienced prostate biopsy Prostata-Volumenrate cc the first time. All patients underwent a 10 core biopsy protocol with an additional 1 core from each suspicious area detected by transrectal ultrasound. Prostate volume was divided into quartiles, namely The optimum number of biopsy cores was determined in patients with different prostate volumes.
Prostata-Volumenrate cc Median age was 63 years and prostate specific antigen was 7. Of patients Cancer detection rates decreased significantly from There was an obvious positive trend in cancer detection rates in favor of the 10 core biopsy protocol over sextant biopsies Prostata-Volumenrate cc all patient groups. Classic sextant biopsy protocol proved to be inadequate for all prostate volumes. The Prostata-Volumenrate cc of the 10 core biopsy protocol in patients with a prostate volume of between Conclusions: The 10 core biopsy protocol must be used in all group of patients except patients with a prostate volume of In patients with a prostate volume of The classic sextant biopsy protocol seemed inadequate for all prostate volumes.
Patients with a larger prostate had lower cancer detection rates. KEY WORDS: prostate; biopsy; prostatic neoplasms; ultrasound, high-intensity focused, transrectal Transrectal ultrasonography TRUS guided prostate nee- patients who underwent biopsy for the first time and noted a dle biopsy has become the method of choice for the diagnosis Uzzo7 and Karakiewicz8 et al patients undergoing repeat sextant biopsies. Similarly strategies consisting of 8 to 13 biopsies since this strategy Letran et al reported that the Prostata-Volumenrate cc biopsy protocol was not has not been associated with an increase in morbidity and appropriate in patients with prostate gland volume Prostata-Volumenrate cc the number of clinically insignificant prostate cancers.
However, their study cording to site and submitted separately in 10 formalin filled was Prostata-Volumenrate cc on a mathematical method and it lacked clinical containers to the department of pathology at our institution. Cancer detection rates for the biopsies of different anatomi- In this clinical study we investigated the relationship be- cal regions were compared.
The Prostata-Volumenrate cc was used for the statistical evaluation. Univariate relative yield of 10 core, and probable 6 and 8 core biopsy analysis between Prostata-Volumenrate cc cancer and noncancer groups was done protocols over that of the classic sextant biopsy protocol was with Prostata-Volumenrate cc Mann-Whitney U test. Univariate analyses of clin- determined in patients with different prostate gland vol- ical values according to Prostata-Volumenrate cc variables were Prostata-Volumenrate cc by logis- umes.
All patients underwent prostate biopsies for the first time. Digital rectal examination was not suspicious in biopsy and prostate volumes were calculated by the ellipsoid of the patients Prostata-Volumenrate cc lesions were Prostata-Volumenrate cc prostate formula. All lesions detected by TRUS were noted.
In 2 of these to prostate apex and base. All patients were placed in the left patients 1. Overall of cases We used an 18 gauge core Prostata-Volumenrate cc needle prostate cancer. All pa- Median age and PSA in patients with prostate cancer were tients underwent a 10 core biopsy protocol with an additional significantly higher than in noncancer patients table 1.
In addi- Also, prostate and transitional zone volume in patients with tion to the sextant technique, 4 more biopsies were obtained cancer were significantly less than in their noncancer coun- from the lateral peripheral zone see figure. All biopsies were performed with a type transrectal Table 2 shows prostate cancer detection rates, and clinical ultrasound scanner, an type probe and a Prostata-Volumenrate cc type and biopsy characteristics by prostate volume quartiles.
Prostate vol- cer detection rates decreased significantly as prostate volume umes were divided into quartiles, namely Patients with a larger prostate 50, All 10 biopsy specimens were labeled ac- biopsy cores decreased from The additional yield of lateral peripheral bi- opsies increased with increasing prostate volumes tables 2 and 3. Table 3 shows the unique cancer detection rates of each biopsy region, as stratified by prostate volume quartiles.
Lesion biopsies had the lowest cancer detection rates for all prostate volume quartiles table Prostata-Volumenrate cc. Lateral mid gland and lateral base biopsy cores had the highest cancer Prostata-Volumenrate cc rates table 3. Table 4 lists cancer Prostata-Volumenrate cc rates for the classic sextant protocol and for various biopsy schemes 6 to 10 cores.
Of sextant biopsy protocols laterally placed cores including the apex, lateral mid gland and lateral base seemed as optimal as the 6 core biopsy scheme table 4. The 8 core Prostata-Volumenrate cc scheme consisting of the apex, mid gland, lateral mid gland and lateral base showed the highest cancer detection rate of all 8 core schemes in patients with a prostate volume of between TABLE 1.
Patient clinical and biopsy characteristics according to prostate volume quartiles Vol Quartiles cc p 1 2 3 4 Value Vol range cc Unique cancer detection rates by biopsy core side prostate volume.
Ca 63 37 Prostata-Volumenrate cc 26 studies provided specific recommendations on the number of Apex 4. Presti at al found that Mid gland 3. Unsurprisingly patients with a larger prostate were older, con- sistent with studies showing an increased Prostata-Volumenrate cc and preva- In addition, this 8 core regimen lence of Prostata-Volumenrate cc prostatic hyperplasia with age.
There was an rum PSA and log prostate volume in conjunction with age. Also, Prostata-Volumenrate cc and Prostata-Volumenrate cc zone volumes in patients groups with a prostate volume of The optimal 8 core biopsy scheme cer counterparts table 1.
Overall 92 However, most of these studies only crudely addressed of patients In the current series the cancer detection rates signifi- There were only 7 serious complications 1. Complication rates were not different ac- lished data. Although cancer Prostata-Volumenrate cc present Prostata-Volumenrate cc the Prostata-Volumenrate cc demonstrate that more biopsy cores increase the lesion directed biopsies of patients, 2 of these patients chance of prostate cancer detection.
Uzzo et al stated that Prostata-Volumenrate cc who pling of the peripheral zone by lateral biopsies. The same protocol had a cancer detection rate of than 35 cc.
The 8 core biopsy scheme, consisting of the apex, base, for all prostate volumes. Patients with a Prostata-Volumenrate cc prostate had lateral mid gland and lateral base, did not attain the cancer lower cancer detection rates.
Additional biopsies from lateral detection rates of the 10 core Prostata-Volumenrate cc in every quartile peripheral regions increased cancer detection by Therefore, we recommend using the 10 The classic sextant 1. Hodge, K. J Prostata-Volumenrate cc, 71, Prostata-Volumenrate cc 4. The optimal sextant biopsy protocol may be a sex- 2. Norberg, M. The lateral sextant biopsies of the prostate underestimates the presence of cancer. The differ- 3.
Ravery, V. However, even at volumes less tection rate of prostate cancer. Eskew, L. J Urol,do not pose any additional risk to the patient table 4. Presti, J. In the current series median Prostata-Volumenrate cc was 7. Eskicorapci, S. Also, the Gleason score 2 to 4 rate in our patient detection of prostate cancer. Eur Urol,group was much higher than observed in the United Series.
Uzzo, R. Urology,to that in a recent multicenter Prostata-Volumenrate cc from Turkey. Karakiewicz, P. Urology, 55, In our group we noted 1. Letran, J. J Urol,cores. In addition, there was no correlation between the com- Vashi, A. J Urol, Prostata-Volumenrate cc, J. Urology, Beurton, D. Since ing carcinoma: a prospective randomized study.