A randomised trial comparing two protocols for transrectal prostate repeat biopsy : six lateral posterior plus six anterior cores versus a standard posterior 12-core biopsy
(2019) In Scandinavian Journal of Urology 53(4). p.217-221- Abstract
Objective: To test the hypothesis that a combination of 6 posterior and 6 anterior cores detects more cancer than 12 posterior cores at a repeat transrectal prostate biopsy in men who have had one previous benign systematic biopsy. Patients and methods: Three hundred and forty men with persistently raised serum PSA were randomly allocated 1:1 to either a standard 12-core biopsy (12 cores from the lateral peripheral zone through a side-fire biopsy canal) or an experimental 12-core biopsy protocol with 6 anterior cores through an end-fire biopsy canal and 6 cores from the lateral peripheral zone through a side-fire biopsy canal. All biopsies were obtained transrectally with ultrasound guidance. The primary endpoint was cancer detection.... (More)
Objective: To test the hypothesis that a combination of 6 posterior and 6 anterior cores detects more cancer than 12 posterior cores at a repeat transrectal prostate biopsy in men who have had one previous benign systematic biopsy. Patients and methods: Three hundred and forty men with persistently raised serum PSA were randomly allocated 1:1 to either a standard 12-core biopsy (12 cores from the lateral peripheral zone through a side-fire biopsy canal) or an experimental 12-core biopsy protocol with 6 anterior cores through an end-fire biopsy canal and 6 cores from the lateral peripheral zone through a side-fire biopsy canal. All biopsies were obtained transrectally with ultrasound guidance. The primary endpoint was cancer detection. Secondary endpoints were detection of ISUP Grade Groups/Gleason Grade Group ≥2 cancer, total biopsy cancer length and complications leading to medical intervention. Results: Prostate cancer was detected in 42/168 men (25%) in the experimental biopsy group and in 36/172 (21%) in the standard biopsy group (p = 0.44). The corresponding proportions for Gleason score ≥7 were 12% and 7% (p = 0.14). Median total cancer length was 4 (inter quartile range [IQR] = 1.5 − 6) mm in the end-fire group and 3 (IQR = 1.3 − 7) mm in the side-fire group. Ten men in the end-fire group and three in the side-fire group had a medical intervention for biopsy-related complications (p = 0.05). Conclusion: The biopsy protocol that included six end-fire anterior cores did not detect more cancer and was associated with more complications.
(Less)
- author
- Örtegren, Joakim ; Holmberg, Jan Tage LU ; Lekås, Edvard ; Mana, Sabah ; Mårtensson, Stig ; Richthoff, Jonas LU ; Sundqvist, Pernilla ; Kjölhede, Henrik LU ; Bratt, Ola LU and Liedberg, Fredrik LU
- organization
- publishing date
- 2019
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- anterior biopsies, end-fire, Prostate cancer, randomized, rebiopsy, side-fire
- in
- Scandinavian Journal of Urology
- volume
- 53
- issue
- 4
- pages
- 217 - 221
- publisher
- Taylor & Francis
- external identifiers
-
- scopus:85067653091
- pmid:31204873
- ISSN
- 2168-1805
- DOI
- 10.1080/21681805.2019.1628102
- language
- English
- LU publication?
- yes
- id
- 6b748751-c21c-4095-8ed9-599a10d6ad7e
- date added to LUP
- 2019-07-08 14:03:39
- date last changed
- 2024-09-18 06:33:14
@article{6b748751-c21c-4095-8ed9-599a10d6ad7e, abstract = {{<p>Objective: To test the hypothesis that a combination of 6 posterior and 6 anterior cores detects more cancer than 12 posterior cores at a repeat transrectal prostate biopsy in men who have had one previous benign systematic biopsy. Patients and methods: Three hundred and forty men with persistently raised serum PSA were randomly allocated 1:1 to either a standard 12-core biopsy (12 cores from the lateral peripheral zone through a side-fire biopsy canal) or an experimental 12-core biopsy protocol with 6 anterior cores through an end-fire biopsy canal and 6 cores from the lateral peripheral zone through a side-fire biopsy canal. All biopsies were obtained transrectally with ultrasound guidance. The primary endpoint was cancer detection. Secondary endpoints were detection of ISUP Grade Groups/Gleason Grade Group ≥2 cancer, total biopsy cancer length and complications leading to medical intervention. Results: Prostate cancer was detected in 42/168 men (25%) in the experimental biopsy group and in 36/172 (21%) in the standard biopsy group (p = 0.44). The corresponding proportions for Gleason score ≥7 were 12% and 7% (p = 0.14). Median total cancer length was 4 (inter quartile range [IQR] = 1.5 − 6) mm in the end-fire group and 3 (IQR = 1.3 − 7) mm in the side-fire group. Ten men in the end-fire group and three in the side-fire group had a medical intervention for biopsy-related complications (p = 0.05). Conclusion: The biopsy protocol that included six end-fire anterior cores did not detect more cancer and was associated with more complications.</p>}}, author = {{Örtegren, Joakim and Holmberg, Jan Tage and Lekås, Edvard and Mana, Sabah and Mårtensson, Stig and Richthoff, Jonas and Sundqvist, Pernilla and Kjölhede, Henrik and Bratt, Ola and Liedberg, Fredrik}}, issn = {{2168-1805}}, keywords = {{anterior biopsies; end-fire; Prostate cancer; randomized; rebiopsy; side-fire}}, language = {{eng}}, number = {{4}}, pages = {{217--221}}, publisher = {{Taylor & Francis}}, series = {{Scandinavian Journal of Urology}}, title = {{A randomised trial comparing two protocols for transrectal prostate repeat biopsy : six lateral posterior plus six anterior cores versus a standard posterior 12-core biopsy}}, url = {{http://dx.doi.org/10.1080/21681805.2019.1628102}}, doi = {{10.1080/21681805.2019.1628102}}, volume = {{53}}, year = {{2019}}, }