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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
Section of Urology, Department of Surgery, Växjö County Hospital, Växjö, Sweden; epartment of Urology, Institute of Clinical Science, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
Section of Urology, Department of Surgery, Växjö County Hospital, Växjö, Sweden; Section of Urology, Department of Surgery, Ljungby Hospital, Ljungby, Sweden.
Section of Urology, Department of Surgery, Växjö County Hospital, Växjö, Sweden.
Section of Urology, Department of Surgery, Ljungby Hospital, Ljungby, Sweden.
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2019 (English)In: Scandinavian journal of urology, ISSN 2168-1805, E-ISSN 2168-1813, p. 1-5Article in journal (Refereed) Epub ahead of print
Abstract [en]

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.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. p. 1-5
Keywords [en]
Prostate cancer, anterior biopsies, end-fire, randomized, rebiopsy, side-fire
National Category
Urology and Nephrology Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-74756DOI: 10.1080/21681805.2019.1628102ISI: 000475102100001PubMedID: 31204873OAI: oai:DiVA.org:oru-74756DiVA, id: diva2:1328092
Funder
Swedish Cancer Society, 2017/278
Note

Funding Agency:

FoU Kronoberg and Cancerstiftelsen Kronoberg

Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-07-29Bibliographically approved

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Sundqvist, Pernilla

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