The importance of prostate volume in prostate needle biopsy

Although ultrasound-guided prostate needle biopsy is the gold standard method in the diagnosis of prostate cancer, biopsy schemes and the number of repeated biopsies are still controversial today. It is known that the rate of prostate cancer decreases with increasing prostate volume. In this study, we evaluated the effects of prostate volume on cancer detection in our patient series.

In our clinic, data for 992 patients who had gray zone PSA levels (2.5-10 ng/mL) and whose 10 core biopsies were taken between 2004 and 2010 were evaluated. Among them, 500 patients from whom 6 to 8 biopsies were taken, whose information was lacking and who had suspicious cancer findings after digital rectal examination were excluded from the study. Patient ages, free/total PSA levels (f/TPSA), PSA densities (PSAD), Gleason scores, and prostate volumes were compared between patients with (Group 1) or without biopsy-proven prostate cancer (Group 2). Student's t-test was used for statistical analysis.

According to biopsy findings, prostate cancer was detected in 74 patients while no cancer was detected in 418 patients. The mean age of Groups 1, and 2 were 65±8.6, and 64±8.1 years, respectively The mean prostate volume in Groups 1, and 2 were 45±23 cc, and 58±26 cc, respectively.

In line with the literature, the average prostate volume of the prostate cancer group was significantly lower. This supports the notion that cancer detection is more probable in small prostates than in high-volume prostates.