Urologist's Impact on Needle Core Prostate Biopsy Histopathologic Variables within a Single Institution.

OBJECTIVE - To assess the urologist's impact on prostate needle core biopsy variables including number of containers submitted, total core length, longest core length, and individual core length threshold values and to elucidate the relationship between these variables and cancer detection rate within a recent cohort.

METHODS - A retrospective search was performed to identify patients who had an extended transrectal ultrasound guided prostate needle core biopsy between 2008-2013.

RESULTS - 1,001 prostate biopsies were analyzed. Total core length (mean 13.2-22.9 cm, P<.001) significantly varied by submitting urologist but did not impact cancer detection rate per case. Increased core length per container impacted the cancer detection per container (P<.001). The number of cores that met threshold values of 0.5, 1.0, and 1.5 cm as well as longest individual core length (mean 1.7-2.2 cm) significantly varied between urologist (P<.001), although there was no association between these variables and cancer detection. Container number differed significantly between urologists (P<.001) but did not correlate with cancer detection. For the single urologist with a change in his submission protocol during the study period, a non-significant change in cancer detection was noted when comparing 12-14 containers versus 6-9 containers.

CONCLUSIONS - Submitting urologist significantly impacts prostate biopsy metrics. An increased amount of tissue per container was associated with higher rates of cancer per container. A non-significant change in cancer detection rate was observed when container number was reduced from 12-14 to 6-9.

Urology. 2016 Feb 22 [Epub ahead of print]

Kashika G Goyal, Joshua J Ebel, Soud A Sediqe, David S Sharp, Debra L Zynger

Department of Pathology, The Ohio State University Medical Center, Columbus, OH 43210. Department of Urology, The Ohio State University Medical Center, Columbus, OH 43210.  Department of Pathology, The Ohio State University Medical Center, Columbus, OH 43210.  Department of Urology, The Ohio State University Medical Center, Columbus, OH 43210. Department of Pathology, The Ohio State University Medical Center, Columbus, OH 43210; Department of Urology, The Ohio State University Medical Center, Columbus, OH 43210. 

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