Saturation Technique Does Not Decrease Cancer Detection During Followup After Initial Prostate Biopsy

Main Category: Prostate / Prostate Cancer
Also Included In: Urology / Nephrology;  Men's health
Article Date: 19 Apr 2008 - 0:00 PDT

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UroToday.com - This is a good example of why we perform research and assess outcomes with hard data, because in the field of prostate biopsy, we have plenty of experience demonstrating that many of our assumptions, based on common sense alone, are ultimately proven wrong.

In this example, over 5 years ago, our group found that our ability to perform saturation prostate biopsy in the office using local anesthetic was well tolerated. We also found no increase in bleeding, pain, infection, or other complications compared to sextant biopsy. Therefore, common sense said that we might as well use this as an initial biopsy strategy, in order to find all cancers on the first biopsy, instead of reserving for repeat biopsy. As it turns out, common sense was wrong, and we found that the detection rate was no higher in our hands when we used saturation biopsy as an initial biopsy strategy than it was when we did extended 10-12 core biopsies.

The piece of the puzzle that the present report fills in is to allow us to know how many of these men would ultimately be found to have prostate cancer. In this report, we followed these men for 2-3 years and found that as many had a positive biopsy during repeat biopsy as we would expect following 12 core biopsy, putting a nail in the coffin for saturation biopsy as an initial biopsy.

This doesn't detract from the value of saturation biopsy for repeat biopsy, and we continue to use it for all repeat biopsies based on detection rates that we have previously reported, and the tolerability that leaves no reason not to use it for repeat biopsy.

Written by J. Stephen Jones, MD, FACS, as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given an opportunity to expand on the circumstances, limitations, etc., of their research by referencing the published abstract.

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