Is an extended 20-core prostate biopsy protocol more efficient than the the standard 12-core? A randomized multicenter trial - Abstract

PURPOSE: The aim of this study was to determine the impact of increasing the number of cores from 12 to 20 at initial prostatic biopsy (PB) in men suspicious of prostate cancer (PCa).

MATERIAL AND METHODS: From December 2009 to November 2011, patients in 7 centers scheduled for a first PB, with a PSA < 20 ng/mL and no nodule on digital rectal examination, were invited to participate in this superiority trial. Patients were randomized to a 12-core (PB12 group) or a 20-core (PB20 group) protocol. The primary end point was cancer detection rate (CDR). Secondary end points were cancer characteristics, rate of complications and patient's tolerance assessed by a self-completed booklet before PB and at day 5 and day 15.

RESULTS: A total of 339 patients were randomized. Preoperative variables were similar in both groups. Cancer was detected in 71 patients (42.0%) in PB12 group and in 81 patients (48.8%) in PB20 group: the difference was not significant (p>0.2). Gleason score and cancer length measured on PB cores were not significantly different between groups. Although CDR rate was linked to prostate volume, this was not affected by the number of extracted cores (p> 0.4). Complications number and seriousness were comparable in both arms. No significant difference was noted regarding side-effects and tolerance as self-assessed by the patient at day 5 and day 15 following PB.

CONCLUSIONS: Our findings suggest that there is no significant advantage in using a 20-core biopsy protocol vs 12-core protocol during an initial

Written by:
Irani J, Blanchet P, Salomon L, Coloby P, Hubert J, Malavaud B, Mottet N.   Are you the author?
Department of Urology, CHU La Miletrie, Poitiers, France.

Reference: J Urol. 2013 Jan 9. pii: S0022-5347(13)00011-6.
doi: 10.1016/j.juro.2012.12.109

PubMed Abstract
PMID: 23313205 Prostate Cancer Section