Transperineal template‐guided prostate biopsy: 10 years of experience
Open Access
- 18 December 2014
- journal article
- research article
- Published by Wiley in BJU International
- Vol. 117 (3), 424-429
- https://doi.org/10.1111/bju.13024
Abstract
Objective To assess the efficacy and safety of transperineal template‐guided prostate biopsy. Materials and Methods From December 2003 to December 2013, a total of 3 007 patients (30–91 years old, mean age 69.1) who met the inclusion criteria underwent 11‐region transrectal ultrasound‐guided transperineal template prostate biopsy. The inclusion criteria included a prostate‐specific antigen (PSA) level of 4.0 ng/mL or greater and abnormal prostate gland findings on digital rectal examination, ultrasound, CT or MRI. The median PSA level was 11.0 ng/mL (range 0.2–100 ng/mL). The prostate cancer detection rate and prostate biopsy adverse effects, as well as prostate cancer spatial distribution were analyzed. Results A mean of 19.3 cores (range 11–44) were obtained for each biopsy, and more cores were obtained in larger prostates than in smaller ones. One to four cores were collected from each region. Prostate cancer was detected in 1 067 of the 3 007 patients (35.5%). The prostate cancer detection rates in groups with PSA levels of 0–4.0 ng/mL, 4.1–10.0 ng/mL, 10.1–20.0 ng/mL, 20.1–50.0 ng/mL, and 50.1–100.0 ng/mL were 15.3% (27/176), 21.0% (248/1 179), 32.6% (318/975), 56.0% (232/414), and 92.0% (241/262), respectively. The mean positives for cancer in regions 1–10 and region 11 (the apical region) were 46.7% vs 52.0% (P = 0.014). Regarding adverse effects, 47.0% of the patients reported hematuria, 6.1% developed hemospermia, 1.9% required short‐term catheterization after biopsy because of acute urinary retention, and 0.03% (one patient) developed urosepsis. Conclusions Transrectal ultrasound‐guided transperineal template prostate biopsy is safe and accurate. The current study suggests that prostate carcinoma foci are more frequently localized in the apical region.Keywords
This publication has 22 references indexed in Scilit:
- Critical Evaluation of Magnetic Resonance Imaging Targeted, Transrectal Ultrasound Guided Transperineal Fusion Biopsy for Detection of Prostate CancerJournal of Urology, 2013
- Prostate biopsy: results and advantages of the transperineal approach—twenty-year experience of a single centerWorld Journal of Urology, 2013
- Location and Pathological Characteristics of Cancers in Radical Prostatectomy Specimens Identified by Transperineal Biopsy Compared to Transrectal BiopsyJournal of Urology, 2012
- Characteristics and clinical significance of prostate cancers missed by initial transrectal 12-core biopsyBJU International, 2011
- Trans-rectal Versus Trans-Perineal Saturation Rebiopsy of the Prostate: Is There a Difference in Cancer Detection Rate?Urology, 2011
- ‘Prostatic evasive anterior tumours’: the role of magnetic resonance imagingBJU International, 2010
- Transperineal Ultrasound-Guided Saturation Biopsies Using 11-Region Template of Prostate: Report of 303 CasesUrology, 2007
- Utility of saturation biopsy to predict insignificant cancer at radical prostatectomyUrology, 2005
- Detection of prostate cancer: a comparative study of the diagnostic efficacy of sextant transrectal versus sextant transperineal biopsyUrology, 2000
- Latent carcinoma of prostate at autopsy in seven areas. Collaborative study organized by the International Agency for Research on Cancer, Lyons, FranceInternational Journal of Cancer, 1977