The diagnostic ability of an additional midline peripheral zone biopsy in transrectal ultrasonography-guided 12-core prostate biopsy to detect midline prostate cancer

The goal of this study was to evaluate the diagnostic effect of adding a midline peripheral zone (PZ) biopsy to the 12-core biopsy protocol used to diagnose prostate cancer (PC), and to assess the clinical and pathologic characteristics of midline-positive PC in order to identify a potential subgroup of patients who would require midline PZ biopsy.

This study included 741 consecutive patients who underwent a transrectal ultrasonography-guided, 12-core prostate biopsy with an additional midline core biopsy between October 2012 and December 2013. We grouped patients by the presence or absence of PC and subdivided patients with PC based on the involvement of the midline core. The clinical characteristics of these groups were compared, including serum prostate-specific antigen (PSA) concentrations, PSA density, and pathological features in the biopsy specimens.

PC was detected in 289 patients (39. 0%). Among the PC patients, 66 patients (22. 8%) had midline PC. No patients were diagnosed with PC based only on a midline core. The Gleason scores, number of positive cores, tumor core length, serum PSA concentrations, and PSA density were significantly higher in patients with midline-positive PC (P

Patients showing a positive result for PC in a midline PZ biopsy were more likely to have multiple tumors or large-volume PC with a high tumor burden. However, our data indicated that an additional midline core biopsy is unlikely to be helpful in detecting occult midline PC.

Ultrasonography (Seoul, Korea). 2015 Aug 18 [Epub ahead of print]

Inpyeong Hwang, Sang Youn Kim, Jeong Yeon Cho, Myoung Seok Lee, Seung Hyup Kim



Newsletter subscription

Free Daily and Weekly newsletters offered by content of interest

The fields of GU Oncology and Urology are rapidly advancing. Sign up today for articles, videos, conference highlights and abstracts from peer-review publications by disease and condition delivered to your inbox and read on the go.