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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

Artikel i vetenskaplig tidskrift
Författare Joakim Örtegren
J. T. Holmberg
E. Lekas
S. Maria
S. Martensson
J. Richthoff
P. Sundqvist
Henrik Kjölhede
Ola Bratt
F. Liedberg
Publicerad i Scandinavian Journal of Urology
Volym 53
Nummer/häfte 4
Sidor 217-221
ISSN 2168-1805
Publiceringsår 2019
Publicerad vid Institutionen för kliniska vetenskaper, Avdelningen för urologi
Sidor 217-221
Språk en
Länkar dx.doi.org/10.1080/21681805.2019.16...
Ämnesord Prostate cancer, rebiopsy, end-fire, side-fire, randomized, anterior biopsies, cancer detection rates, template biopsies, ultrasound probe, multicenter, accuracy, tumors, Urology & Nephrology
Ämneskategorier Urologi och njurmedicin

Sammanfattning

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.

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