Clinical and pathologic XXXX characteristics of @entity263 as a function of the number of biopsy cores: a retrospective study.

@entity1 @entity263 @entity5 @entity1486
OBJECTIVES: Many @entity1 with negative prostate biopsies and persistently elevated serum total @entity1486 (tPSA) values will have @entity5 detected on a repeated biopsy. An important issue is whether the @entity5 would have been detected on the initial biopsy had more biopsy samples been obtained. The objective of our study was to retrospectively characterize the clinical and pathologic @entity5 features associated with @entity1 who underwent sextant core biopsies compared with @entity1 who needed more than six core biopsies during one or more biopsy sessions to detect @entity263 . Transrectal ultrasound (TRUS)-estimated prostatic volume was evaluated to determine whether the number of biopsy cores needed for @entity263 detection was influenced by gland size. METHODS: We retrospectively evaluated the number of biopsy core samples obtained in 185 @entity1 (mean age 63+/-6 years) enrolled in our PSA-based screening study for @entity263 who were found to have @entity263 and elected radical prostatectomy as treatment. Correlation coefficients were calculated and univariate analyses were performed to evaluate clinical (age, tPSA, TRUS volume, PSA density) and pathologic (Gleason score, pathologic weight, organ confinement, "possibly harmless" @entity5 ) characteristics associated with @entity1 who required more biopsy cores to detect the @entity5 . RESULTS: Of the 185 @entity1 , 103 (56%) had 6 or fewer total biopsy cores taken and 82 (44%) had more than 6 cores (44 [24%] of 185 had 7 to 12 cores and 38 [20%] of 185 had 13 or more cores). There was a positive correlation between age, serum tPSA, TRUS-determined prostate volume, and pathologic specimen weight and an increasing number of total cores (all P values < 0.05). The number of biopsy cores was not associated with PSA density, Gleason score, @entity5 volume, organ confinement, or "possibly harmless" @entity5 (all P values > 0.05). @entity1 with a TRUS volume 30 cc or less (46%) required a mean of 8 total cores to detect the @entity5 compared with a mean of 11 cores (P = 0.003) in @entity1 with a TRUS volume greater than 30 cc (54%). A greater percentage of @entity1 with a TRUS prostate volume greater than 30 cc compared with @entity1 whose volume was 30 cc or less would have had their @entity5 missed with only a six-core biopsy (64% versus 46%, P = 0.01). CONCLUSIONS: Sextant core biopsies may be @entity263 in some @entity1 . These data support the performance of more than six core biopsies to detect clinical @entity263 . A prospective trial using TRUS-determined prostate volume to determine the number of cores to take is needed to accurately assess this issue.
