Ces Urol 2012, 16(3):163-170 | DOI: 10.48095/cccu2012028

Predictive factors for prostate cancer detection using saturation prostate biopsy

Otakar Čapoun, Roman Sobotka, Petr Macek, Tomáš Hanuš

Urologická klinika 1. LF UK a VFN, Praha

Aim:
The aim of this study was to identify parameters predictive of prostate cancer (PC) in saturation prostate biopsy (SPB) and its comparison to outcomes of prostate re-biopsy using the standard technique.

Methods:
A total of 108 patients underwent SPB at the Dpt. of Urology, General Teaching Hospital, Prague between September 2010 and January 2012. Prior to SPB each patient underwent at least one standard biopsy with negative or suspicious result. In addition following parameters were recorded in each patient: Total and free prostate-specific antigen (PSA) value, prostate size, PSA density, number of cores, total length of cores, histological result, number of positive cores, length of PC in millimeters, Gleason score (GS), number of previous biopsies and a total number of cores taken in standard biopsies. The results of SPB were compared to a control group of patients with identical initial parameters that had undergone re-biopsy using the standard prostate biopsy. Relationships between variables were assessed using Spearman's rank correlation coefficient. Control group was selected using the Wilcoxon test. Comparison between the SPB and standard biopsy groups, as well as the effect of baseline parameters on detection of PC was done using the chi-square test.

Results:
Median age was 64 years (50-83), mean PSA level was 10.4 ng/ml (2.64-39.7), mean PSA density was 0.229 (0.043-1.329). Tic classification was recorded in 65.1% of cases. Positive digital rectal exam (DRE) and ultrasonogra-phy finding was present in 21.7% and 28.3% of patients, respectively. Median prostate size was 52 g (17-116). A total of 5 complications was recorded; two septic reactions and three cases of enterorrhagia. Prostate cancer was detected in a total of 35 patients (33%) in 1-8 biopsy cores. Most cases were classified as Gleason score 6 (3 + 3). Only five patients with PC entered an active surveillance protocol. Prostate cancer was found in 22% of cases from the control group of 98 standard biopsies (p = 0.0928). The ratio of free to total PSA (p = 0.0302) and positive DRE (p = 0.0125) were statistically significant in predicting PC detection in SPB.

Conclusion:
Saturation prostate biopsy is a safe method of PC detection. Clinical data showed limited potential of predicting the result of SPB. SPB has a significantly higher PC detection rate compared to standard biopsy.

Keywords: prostate cancer, prostate biopsy, transrectal sonography, diagnostics

Received: April 17, 2012; Accepted: June 6, 2012; Published: June 1, 2012