Does increased needle biopsy sampling of the prostate detect a higher number of potentially insignificant XXXX ?

@entity1 @entity263 @entity5 @entity3 @entity1486
PURPOSE: Several studies have documented that increased biopsy sampling, that is 6 versus 12 biopsy cores, can detect more @entity263 . It is unknown whether increased sampling of the prostate will detect a higher number of potentially insignificant @entity5 . MATERIALS AND METHODS: We searched the surgical pathology files at The Johns Hopkins Hospital for @entity1 in whom prostate needle biopsy was performed by a single urologist between April 1993 and April 2000, and subsequently underwent radical prostatectomy. @entity1 who underwent radical prostatectomy and had 8 core biopsies or less between March 1994 and August 1999 were also studied. Clinically significant @entity5 were defined as those with volume greater than 0.5 cc, Gleason score 7 or greater or nonorgan confined disease. RESULTS: A total of 297 @entity1 with a mean age of 60 years (range 36 to 75) were evaluated. Group 1 consisted of 107 @entity1 with 8 core biopsies or less, including 51 with 6, and group 2 comprised 190 @entity1 with 9 cores or greater, including 145 with 12. The 2 groups were equal in regard to @entity1486 , age, digital rectal examination and transrectal ultrasound gland volume at biopsy. The only difference between the groups was a higher number of cores with @entity5 in group 2 (mean 2.8 versus 2.1, p = 0.0006). Of the @entity1 who underwent radical prostatectomy 59.6% had Gleason score 6 or less, 26.3% 3+4, 6.7% 4+3 and 7.4% 8 to 9. There were 12.4% of @entity1 with positive margins, 36.4% extraprostatic extension, and 5.4% seminal vesicle invasion and/or lymph node @entity3 . @entity5 volumes averaged 1.1 cc (range 0.01 to 10.7) and 60.9% of @entity5 were greater than 0.5 cc. Clinically significant @entity5 were seen in 77.4% of @entity1 in group 1 and 74.6% in group 2. There was no significant difference in Gleason score, margin status, @entity5 volume, seminal vesicle invasion, or lymph node @entity3 between groups 1 and 2, or in a subset analysis of @entity1 with 6 versus 12 core biopsies. However, @entity1 in whom @entity5 was diagnosed with 9 core biopsies or greater were more likely to have organ confined disease (p = 0.02). CONCLUSIONS: Although increased sampling of the prostate does not increase the detection of potentially insignificant @entity5 , it does appear to detect earlier stage @entity5 .
