Sixteen hearts better than 12 for the detection of prostate cancer -
By Joanna Lyford first medwireNews Reporter
sixteen-core prostate biopsy has cancer detection rate slightly higher 12-core biopsy, but with a similar safety profile and no increase in the detection of clinically insignificant tumors, studying the results show.
The research was done by Yasuhide Miyoshi (Yokohama City University, Japan) and team and included 332 men with prostate specific antigen (PSA) levels in the range of 4.0 to 20.0 ng / mL.
All patients underwent a transrectal biopsy and the removal of the ultrasound-guided needle, or 12 (n = 195) or 16 (n = 137) of the cores. The decision on the number of cores to be taken was not randomized but reflects local protocols; well, men in the 16-core group were significantly younger and had higher PSA levels than those in the 12-core group.
Prostate cancer was detected in 33.8% of men who had taken 12 cores and 44.5% of those with 16 cores; this difference did not reach statistical significance. However, 16-core biopsy found much more than 12 cancer-core biopsy in two sub-groups of men - those with prostate volume greater than 30 ml (29.4 vs 15.5%) and those with PSA density less than 0.2 (34.0 vs. 6.3%).
The anatomical distribution of cancers detected did not differ between the two biopsy methods; nor the pathological tumor grade or proportion of cancers that were considered clinically significant.
Importantly, the periprocedural risks and complications were similar between the two approaches, without cases of urinary tract infection and low rates of haematuria and urinary retention.
Writing in Urology Journal , Miyoshi and the team agree that the optimal number of cores obtained prostate biopsy is uncertain and can not be definitively demonstrated in a prospective randomized trial .
Nevertheless, this study adds to previous work showing that prolonged prostate biopsies "are superior to sextant protocols" for the detection of prostate cancer.
Furthermore, this study suggests that 12-core biopsy "may be insufficient in patients with large volume of prostate or low PSA [density]," they wrote.
they conclude that "16-core prostate biopsy is safe and feasible for Japanese patients with levels of 4.0 to 20.0 ng PSA serum studies /mL."
"further in different populations with a larger sample size is needed to draw definitive conclusions"
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