Xiaojun Deng,Jian Chu,Bo Yang,Feng Liu,Weifeng Wang,Jidong Hao,Jiansheng Wan,Hui Liu. Is extended biopsy protocol justified in all patients with PSA ≥ 20 ng/mL?. Oncol Transl Med, 2014, 13: 422-426.
Is extended biopsy protocol justified in all patients with PSA ≥ 20 ng/mL?
Received:July 01, 2014  Revised:August 18, 2014
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KeyWord:biopsy; prostate cancer (PCa); extend; detection rate; prostate-specific antigen (PSA)
Author NameAffiliationE-mail
Xiaojun Deng Pudong New Area Zhoupu Hospital, Shanghai 201318, China deng810729@126.com 
Jian Chu The 411 Hospital of People's Liberation Army, Shanghai 200081, China  
Bo Yang Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China  
Feng Liu Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China  
Weifeng Wang Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China  
Jidong Hao Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China  
Jiansheng Wan Department of Urology, Pudong New Area Zhoupu Hospital, Shanghai 201318, China  
Hui Liu Pudong New Area Zhoupu Hospital, Shanghai 201318, China liuhui600706@126.com 
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Abstract:
      Objective: The aim of this study was to investigate whether it was necessary to increase the number of cores at initial prostate biopsy with patients of prostate-specific antigen (PSA) ≥ 20 ng/mL and to explore an appropriate individualized transrectal ultrasonograhpy (TRUS)-guided prostate biopsy for the detection of prostate cancer in men suspicious of prostate cancer. Methods: A total of 115 patients with PSA ≥ 20 ng/mL and suspicious of prostate cancer were prospectively randomized to perform TRUS-guided biopsy. Patients were randomized to a “6 X” cores or a “10 X” cores protocol. The primary end point was cancer detection rate. Secondary end points were cancer characteristics, rate of complications and the level of pain experienced by patients during TRUS-guided prostate biopsy. Results: Preoperative variables were similar in both groups. The overall prostate cancer detection rate was 73.9%. The “10 X” cores strategy increased cancer detection rate only 9.7% in patients with PSA ≥ 20 ng/mL but < 50 ng/mL, while there was no difference between the two strategies for cancer detection in patients with PSA ≥ 50.1 ng/mL. The number of extended biopsy cores and pain score of extended biopsy in prostate cancer patients increased significantly (P < 0.001). Conclusion: Our findings suggest that there is no significant advantage in using extended biopsy protocol in all patients with PSA ≥ 20 ng/mL.
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