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. 2007 Summer;9(3):93-8.

Prostate biopsy: current status and limitations

Joseph C Presti  1
Affiliations

Prostate biopsy: current status and limitations

Joseph C Presti. Rev Urol. 2007 Summer.

Abstract

The technique of prostate biopsy has evolved over the past 10 years to improve our ability to detect prostate cancer. Extended biopsy schemes can be performed in the office under local anesthesia and are well tolerated. In addition to detection, the role of extended biopsy schemes in refining tumor grading and risk assessment has become better defined. This review discusses the evolution of prostate biopsy techniques from the sextant scheme to the extended scheme and demonstrates the latter's utility in clinical decision making.

Keywords: Prostate biopsy; Prostate cancer.

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Figures

Figure 1
Figure 1
Schematic diagram of biopsy schemes in coronal plane. A. Standard sextant biopsy scheme. B. 5-region biopsy scheme. C. 10-core biopsy scheme. D. 11-core biopsy scheme. Light circles represent transition zone biopsies. E. 12-core biopsy scheme.
Figure 2
Figure 2
Kaplan-Meier estimates of biochemical recurrence rates of patients treated with radical prostatectomy stratified by the percent of cores positive on the biopsy. Pairwise P values: <34% vs 34%–50%, P = .030; < 34% vs > 50%, P < .001; 34%–50% vs > 50%, P = .006. PSA, prostate-specific antigen. Adapted from Freedland SJ et al.
Figure 3
Figure 3
Kaplan-Meier estimates of biochemical recurrence rates of patients treated with radical prostatectomy stratified by a staging system based upon a combination of the 1992 TNM staging system and biopsy laterality (unilateral vs bilateral positive). Log rank P < .001. PSA, prostate-pecific antigen. Adapted from Freedland SJ et al.
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