Comparing 10-Core versus 16-Core Biopsy Protocols in Repeat Prostate Biopsies: A Retrospective, Multivariable Analysis of 950 Veterans Öffentlichkeit
Min, Jea Young (2012)
Published
Abstract
Abstract
Comparing 10-Core versus 16-Core Biopsy Protocols in Repeat
Prostate Biopsies:
A Retrospective, Multivariable Analysis of 950 Veterans
Patients with a high risk for prostate cancer and previously
negative prostate biopsies are
often referred for repeat biopsy procedures. For initial biopsy,
the current literature indicates
that extended sampling protocols with optimal peripheral zone
targeting can increase the
likelihood of detecting cancer. However, there are relatively few
studies that examine the
optimal number of cores for repeat biopsy procedures. In this
retrospective study, we
analyzed 967 consecutive repeat biopsy procedures that used either
10-core or 16-core
biopsy protocols at the Atlanta Veterans Affairs Medical Center
(VAMC). Descriptive
statistics were obtained from univariable analyses comparing the
two protocols.
Multivariable models were built to compare the rates of cancer
detection in the two
protocols and obtain odds ratios and corresponding 95% confidence
intervals (CIs). A
separate multivariable analysis was performed only for subjects who
had their initial biopsy
at the Atlanta VAMC, controlling for additional variables relating
to the initial procedure.
Among subjects who had cancer, the disease characteristics were
compared in the two
protocols. Overall, prostate cancer was detected in 418 subjects
(43.2%), with 36.8% in the
10-core group and 45.7% in the 16-core group. The 16-core group was
more likely to have a
positive biopsy compared to the 10-core group (OR=1.67, 95% CI
1.19-2.35) when
adjusting for potential confounders. In the analysis restricted to
subjects who received their
initial biopsy at the VA the difference between the two groups was
not statistically significant
although the point estimate was larger (OR=2.36, 95% CI 0.90-6.14).
Having an 8-core
initial biopsy and having a high-grade prostatic intraepithelial
neoplasia (HGPIN) on initial
biopsy were positively associated with cancer detection on repeat
biopsy. The proportion of
patients with high grade or high volume cancer was not
significantly different in the two
groups. In summary, we found that 16-core protocol was more likely
to detect cancer
compared to the 10-core protocol. Patient-specific factors such as
previous biopsy and
clinical characteristics should be considered when deciding the
optimal number of cores for
repeat prostate biopsies.
Table of Contents
Table of Contents
Manuscript
Abstract..............................................1
Introduction.........................................2
Methods..............................................3
Results................................................6
Discussion............................................8
Conclusion...........................................12
References..........................................14
Tables.................................................17
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