[Prostatic biopsy technique in the Centre region]

Abstract

Prostate cancer is the most frequent cancer and second cause of cancer mortality in men. The objective of this study was to analyse the prostatic biopsy technique and to verify its conformity with the reference technique of the Centre region.

Material and method: This study concerned first-line biopsies performed and analysed between 01/01/2001 and 31/03/2001 by all pathologists of the Centre region. We analysed the anaesthesia used to perform these biopsies, whether or not the patient was hospitalized, the needle diameter, the use of ultrasound or finger guidance, the operator's specialization and whether he/she worked in the private or public sector, the number of biopsies, the histology request form and the antibiotic prophylaxis used.

Results: Six hundred and twelve reports were sent by laboratories at the request of the regional health insurance fund. There were 562 first-line biopsies, which represented 93% of all biopsies studied Biopsy was performed as an outpatient procedure, the recommended modality, in only 36% of cases; in 10% of cases, hospitalization was justified by a particular clinical context. 11% of biopsies were not ultrasound-guided, particularly in the private sector. Information about histological type, Gleason grade, tumour volume, number of cores invaded and extension to the periprostatic space was present in 46% of cases.

Conclusions: Only 40% of biopsies performed during the first quarter of 2001 complied with recognized quality criteria: ultrasound guidance, as an outpatient procedure or justified hospitalization, without anaesthesia or with local anaesthesia. Improvement of clinical practice probably requires a phase of discussions and negotiations between professionals and authorities to determine a reasonable fee allowing an objective choice adapted to the patient's state of health. The quality of the histological report is not satisfactory at the present time. A standard report was presented by the Réseau Regional de Cancérologie du Centre (Centre Regional Oncology Network) but has not been adopted by all professionals; further discussions are required to develop a simplified grid comprising essential information, especially as the quality of these reports determines treatment decisions.