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Objective of this study was to compare cancer detection rates between two 12-core prostate biopsy schemes taking into account patient characteristics, primarily PSA blood levels. Studywas conducted at General hospital Varaždin and consisted of retrospective part from July 2005 until March 2013 and prospective part from March 2013 until September 2015. We used a 12-core extended biopsy scheme directed to the far lateral areas of the prostate – S1 scheme. From July 2007 biopsies were directed to far lateral areas of prostate and parasagittal area of prostate – S2 scheme. During prospective part of study, biopsies were done using 18-core biopsy scheme (overlapping of two 12-core schemes, S3). Study included1571 patients who underwent biopsy after S1 (n=272), S2 (n=1032) or S3 scheme (n=267). Older age, abnormal digital rectal examination and higher PSA serum level were associated with higher cancer detection rates in all schemes. Highest cancer detection rate was in S3 group. We observed negative association between prostate volume and cancer detection rate. Main finding of study is that relative efficacy of two 12-core biopsy schemes was conditional on PSA level and was not conditional on age, prostate volume or digitorectal examination finding. There was trend of linearly increasing ORs (S1/S2) with the increasing PSA level in patients undergoing inital biopsy (from 1.0 at higher PSA levels), and opposite trend (linearly decreasing OR S1/S2 from >1.0 at low PSA levels to |
