Le biopsie prostatiche random nei tumori prostatici allo stadio T1C: Confronto fra la tecnica a 6 sestanti vs quella a 10 sestanti

Abstract

It is still controversial which prostatic biopsy technique can provide the highest positive rate, complications, prostatic volume and PSA levels being equal. 656 consecutive patients (mean age 62.2 years) were submitted to biopsies using two similar transrectal techniques differing only in the number of biopsies: the “classic” six-sextant and a tensextant technique (adding 4 paraurethral biopsies). Every suspicious or hypoechoic area was also biopsied. Nine per cent (8/89) and 14% (6/42) of the patients subjected to 6-sextant and 10-sextant biopsies respectively, with a PSA level between 4.0-10.0 ng/ml had prostatic cancer. The positive rate increased to 24% (12/49) with sextant plus directed biopsies and to 33% (33/99) with directed biopsies only. Overall, 21% (52/279) of the patients with the above PSA level had a prostatic tumour. The 10-sextant biopsy technique does not seem to be significantly superior to the classic 6-sextant approach.