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Saturation technique does not decrease cancer detection during followup after initial prostate biopsy.

Brian R Lane1, Craig D Zippe, Robert Abouassaly

  • 1Glickman Urological and Kidney Institute, Cleveland Clinic, Cleveland, Ohio 44195, USA.

The Journal of Urology
|March 18, 2008
PubMed
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Initial saturation prostate biopsy does not improve prostate cancer detection rates compared to standard biopsy. Subsequent biopsies after an initial negative saturation biopsy show a similar false-negative rate, questioning its use as a primary strategy.

Area of Science:

  • Urology
  • Oncology
  • Diagnostic Procedures

Background:

  • Saturation prostate biopsy (20+ cores) is proposed to increase cancer detection.
  • Previous studies suggest saturation biopsy as an initial strategy offers no detection advantage over 10-12 core biopsies.

Purpose of the Study:

  • To evaluate the cancer detection rate on subsequent prostate biopsies in men initially undergoing saturation prostate biopsy.
  • To assess the long-term efficacy of saturation biopsy as an initial diagnostic approach for prostate cancer.

Main Methods:

  • A cohort of 257 men underwent initial saturation prostate biopsy between 2002 and 2006.
  • Men with negative initial biopsies were followed with annual PSA and DRE, with repeat saturation biopsy indicated for persistent elevation.
  • Cancer detection rates and characteristics were analyzed for initial and subsequent biopsies.

Related Experiment Videos

Main Results:

  • After a negative initial saturation biopsy, 24% of men (14/59) detected cancer on repeat biopsy due to persistent clinical suspicion.
  • No significant association was found between cancer detection and initial/follow-up PSA levels or initial biopsy findings.
  • Cancers found on repeat biopsy were more often Gleason 6 and organ-confined than those from initial saturation biopsies.

Conclusions:

  • Initial saturation prostate biopsy does not enhance prostate cancer detection rates compared to standard biopsy techniques.
  • The false-negative rate following an initial saturation biopsy is comparable to that of traditional biopsies.
  • These findings support that saturation biopsy is not a superior initial strategy for prostate cancer diagnosis.