Prostate Cancer: Screening and DiagnosisTrans-rectal Versus Trans-Perineal Saturation Rebiopsy of the Prostate: Is There a Difference in Cancer Detection Rate?
Section snippets
Study Population
Data were prospectively collected from 472 men who consecutively underwent an ultrasound-guided 24-core prostate rebiopsy (saturation biopsy) at 2 academic tertiary referral centers. Data analyses for the purpose of this study were done retrospectively. Overall, 332 (70.3%) underwent a transrectal 24-core biopsy at the urology unit of the University Vita-Salute/San Raffaele in Milan. The remaining 140 (29.7%) underwent a transperineal 24-core biopsy at the urology unit of the university of
Results
Table 1 shows the characteristics of 280 matched patients. Average age was 66.3 years (median: 66.6, range: 47.6–82.1). Mean PSA was 9.8 ng/mL (median: 8.6, range: 0.9–31.5). Average total prostate volume was 63.9 mL (median: 58.5, range 15.0–198.0). DRE was pathologic in 11.1% of patients. The rates of a previous HGPIN and ASAP were, respectively, 5.4% and 18.9%. The numbers of previous biopsy sets were 1, 2, 3, and ≥4 in, respectively, 54.3, 31.8%, 11.4%, and 2.5% of patients. Overall, the
Comment
An important factor that may affect the rate of PCa detection of prostate biopsy is the approach used to perform it.6, 9, 10, 11 Theoretically, because the cores of the transperineal approach are directed longitudinally to the peripheral zone of the prostate, this approach should have a better PCa detection ability than the transrectal approach. Moreover, the transperineal approach should allow more accurate sampling of the anterior part of the gland. A previous report observed a higher PCa
Conclusions
Transrectal and transperineal prostate saturation biopsies have a similar likelihood of detecting PCa in men undergoing a saturation rebiopsy. Both approaches can be offered to men undergoing a prostate rebiopsy without undermining the rate of PCa detection.
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