Is extended biopsy protocol justified in all patients with suspected prostate cancer?
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OBJECTIVE: To determine the significance of an extended ten-core transrectal biopsy protocol in different categories of patients with suspected prostate cancer. METHODS: We studied 125 men who were being evaluated for prostate cancer. They all had an extended ten-core digitally-guided transrectal prostatic biopsy done for either an elevated serum PSA or an abnormal digital rectal examination finding or both. Sextant biopsy samples were collected first followed by additional four lateral biopsies in all patients. Both groups of specimen were analyzed separately. The cancer detection rates of both sextant and extended 10-core biopsy protocols at different PSA levels and DRE findings were determined and compared. The level of significance of difference in cancer detection were determined using Pearson’s Chi square and McNemar’s test with level of significance set at <0.05. RESULTS: The overall cancer detection by the extended technique was 61(48.8%) cases while the sextant protocol detected cancer in 52 cases. Ten-core extended protocol yielded an increase in cancer detection rate of 14.8% but the improvement in detection rate was only statistically significant in the sub-set of patients with PSA between 4.1 and 10ng/ml with or without abnormality on DRE with an overall increase detection rate of 33%.(P=0.04). CONCLUSION: Our study has shown that a ten-core prostate biopsy protocol significantly improves cancer detection in patients with suspected early cancer. It should therefore be the optimum biopsy protocol for patients with gray-zone PSA value with or without abnormal DRE.
Biopsy , Detection rate , Digital rectal examination , Extended , Prostate cancer , Research Subject Categories::MEDICINE::Surgery
Ojewola R.W., Tijani K.H., Jeje E.A., Anunobi C.C., Ogunjimi M.A., Ezenwa E.V., Ogundiniyi O.S. Is extended biopsy protocol justified in all patients with suspected prostate cancer. Niger J Clin Pract. 2012;15:315-9.