Keywords:
Genital / Reproductive system male, Ultrasound, Biopsy, Neoplasia
Authors:
N. Boukadoum1, C. H. Kaidi1, A. Chouakria1, A. Lankar1, A. Kadi1, S. Draquat2; 1Annaba/DZ, 2Constantine/DZ
DOI:
10.1594/ecr2012/C-0098
Results
Median patient age was 70 years (range 56 to 86),
median total PSA was 12.5 ng/ml (range 4 to 19,9) and median prostate volume was 66.47 cc (range 18 to 164) in the whole study group.
Digital rectal examination was not suspicious in 116 of the 167 patients (69.5%).
Suspicious lesions were detected on ultrasonography in 61 of the 167 patients (36.5%),
which revealed cancer in 32 patients.
With 12-core scheme,
prostate cancer was detected in 55 patients (33%).
Gleason score was 6 in a 19 cases (34,5%),
7 in 25 cases (45,4%),
8 in 8 cases (14,5%),
9 in 3 cases (5,4 %).
Table 1 reports the prostate cancer detection rate of the 12-core biopsy protocol according to the different clinical variables (Table 1).
At multivariate analysis,
age and digital rectal examination resulted to be independent predictors of prostate cancer detection.
The 6-cores sextant protocol allowed us to detected 32 prostate cancers (19 %).
The best 8-peripheral cores schemes detected 38 prostate cancer (22 %).
The detection rates of the best 10-cores schemes is 27%.
The protocol with 12 biopsies in the peripheral zone diagnosed 55 prostate cancers (33 %).
In patients with a prostate volume lower or equal to 30 cc,
the 12-core protocol identified 1 tumor more than the 6,
8 and 10-cores schemes (p > 0,05).
In patients with a prostate volume ranging between 30.1 to 50 cc,
the 12-core protocol identified 6 tumors (46 %) more than the sextant protocol (p < 0.05); 3 and 1 cases more than the best of the 8 and 10-peripheral cores schemes respectively (p >0,05).
In patients with prostate volume ranging between 50.1 to 70 cc,
the 12-core protocol identified 7 tumors (53 %) more than the 6-cores schemes (p < 0.05); 6 cases more than the best of the 8- cores schemes (p <0,05).
2 cases more than the best of the 10- cores schemes (p >0,05).
In patients with prostate volume greater than 70 cc,
the 12-core biopsy scheme allows the highest detection rate (p < 0.05) (Table 2).
Post-biopsy follow-up was uneventful in all patients.