Comparative Analysis between Sextant Biopsy and 12-samples Needle Biopsy for Detection of Stage T1c Prostate Cancer

Bae, Kwan Sik; Chang, Sung Goo

Abstract

PURPOSE: The incidence of stage T1c prostate cancer has been reported to have increased more than any other prostate cancer. To evaluate whether a sextant biopsy is useful for the detection of stage T1c prostate cancer, the detection rates were compared between the sextant and 12-sample needle biopsies, in relation to the prostate volume (PV) and serum prostate specific antigen (PSA) level.
MATERIALS AND METHODS
Between January, 1986 and December, 2002, 123 patients who were found to be normal upon digital rectal examination, with negative findings on a transrectal ultra sonography (TRUS) examination and elevated serum PSA (>4ng/ml), underwent either a sextant or 12-sample needle biopsy, under local anesthesia, to detect the presence of prostate cancer.
RESULTS
There was no statistically significant difference in the cancer detection rate between the sextant (11/41) and 12-sample (24/82) needle biopsies of the prostate. According to the total PSA level, the detection rates of prostate cancer for the 6 and 12 core groups were 31.6 (6/19) and 22.8% (8/35), respectively, (PSA: 4.1-9.9ng/ml), 23.1 (3/13) and 32.0% (8/25) (PSA: 10.0-19.9ng/ml), and 22.2 (2/9) and 36.4% (8/22) (PSA >or=20.0ng/ml). According to the prostate volume, the detection rates of prostate cancer for the 6 and 12 core groups were 28.6 (2/7) and 31.0% (9/29), respectively (PVor=60ml). Our study did not have the statistical power required to rule out small differences.
CONCLUSIONS
These findings imply that a sextant biopsy constitutes a useful method for the detection of prostate cancer.