Extended sampling at first biopsy improves XXXX detection rate: results of a prospective, randomized trial comparing 12 versus 18-core prostate biopsy.

@entity5 @entity1 @entity263
PURPOSE: We determined whether increasing the number of cores at first prostate biopsy would improve the @entity5 detection rate without increasing the detection of clinically insignificant @entity5 . MATERIALS AND METHODS: From January 2009 to January 2010 @entity1 scheduled for prostate biopsy were randomized to 12 or 18-core sampling. Study inclusion criteria were 1) age 45 to 75 years, 2) abnormal digital rectal examination and/or prostate specific antigen 4 to 20 ng/ml, and 3) no previous biopsy. The primary end point was the @entity5 detection rate. Secondary end points were clinically insignificant @entity5 detection and morbidity. RESULTS: A total of 150 @entity1 were enrolled in the study. Preoperative variables were similar in the 2 groups of 75 @entity1 each. @entity5 was detected in 23 @entity1 (30.7%) in group 1 and in 36 (48%) in group 2 (p = 0.02). More cases of insignificant @entity5 were detected in group 2 (p not significant). In @entity1 with prostate volume 65 cc or less the detection rate was 30.9% in group 1 and 52.8% in group 2 (p = 0.02). In @entity1 with prostate specific antigen 10 ng/ml or less the detection rate was 19.6% in group 1 and 38.4% in group 2 (p = 0.03). Two group 2 @entity1 (5.5%) were diagnosed based on additional samples but the diagnosis corresponded to insignificant @entity5 . There was no statistically significant difference in morbidity. CONCLUSIONS: The 18-core protocol improves @entity263 detection without increasing morbidity. Results suggest that the 12-core biopsy protocol is adequate for @entity263 detection at first biopsy.
