Extended 14-core schematic diagram mapping prostate biopsy increases both the cancer detection rate and the accuracy of Gleason Score

Authors

  • Krittin Nravejsakul Division of Urology, Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
  • Bhapapak Na song-kha Division of Urology, Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
  • Wiroj Raksakul Division of Urology, Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
  • Thitiwat Wongumpornwat Division of Urology, Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand
  • Umaphorn Nuanthaisong Division of Urology, Department of Surgery, Faculty of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand

Keywords:

Extended 14-core schematic diagram mapping, prostate biopsy increases, cancer detection rate

Abstract

Objective:  To evaluate the effectiveness of extended 14-core schematic diagram mapping prostate biopsy for improving the cancer detection rate (CDR) and
accuracy of Gleason score.

Material and Method:  This study included 184 patients who underwent transrectal ultrasound (TRUS)-guided lateral sextant biopsy (group I) and 196 patients who underwent extended 14-core biopsy (group II). Inclusion criteria for prostate biopsy were elevated serum prostate-specific antigen (PSA) levels (>4.0 ng/ml) and/or suspicious digital rectal examination (DRE).

Results:  Median patient age was 69.68 years (± 7.89) and 70.07 years (± 8.83) for group I and II, respectively. Median pre-biopsy PSA was 18.04 (range: 8.42-22.35) and 15.83 ng/ml (range: 6.54-21.72) for group I and II. Out of the first group, 65 (35.3%) patients had prostate cancer, whereas 78 (40.0%) patients of group II had cancers. The overall cancer detection rate was significantly higher in group II (40.0%) than group I (35.3%), p=0.034, and in particular showed a significant
increase in the cancer detection rate in the subgroup with PSA level between 4-10 ng/ml. Moreover, rising Gleason sum after radical prostatectomy was 1 in 3
(11.1%) patients and 2 in 1 (3.7%) patient.

Conclusion:  Extended 14-core schematic diagram mapping prostate biopsy significantly increased the cancer detection rate of prostate cancer and increased
the accuracy of biopsy Gleason score. Thus, schematic diagram mapping prostate biopsy should be the standard ultrasound guided prostate biopsy in our institute for increasing the cancer detection rate and also for planning treatments.

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Published

2020-12-02

How to Cite

Nravejsakul, K., Na song-kha, B., Raksakul, W., Wongumpornwat, T., & Nuanthaisong, U. (2020). Extended 14-core schematic diagram mapping prostate biopsy increases both the cancer detection rate and the accuracy of Gleason Score. Insight Urology, 41(2), 75–80. Retrieved from https://he02.tci-thaijo.org/index.php/TJU/article/view/247858

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