PROSTATE BIOPSY METHODS

Diagnostic value of systematic prostate biopsy methods in the investigation for prostate cancer: a systematic review

Background

Prostate cancer is the second biggest cause of death from cancer in men in the UK with over 10,000 deaths each year. Generally, men suspected of having prostate cancer undergo ultrasound guided biopsy to obtain samples of the prostate for diagnosis. For many years the standard approach has been to use the sextant biopsy scheme, which involves taking six tissue samples (cores). There are now in use a number of more extensive biopsy schemes where a greater number of cores are taken, resulting in wide variation in practice. The subject of this review was the diagnostic accuracy of different biopsy schemes used to detect prostate cancer.

Findings

The sextant biopsy scheme detected fewer cancers than most of the more extensive biopsy schemes. As the number of biopsy samples taken increases, the accuracy of cancer detection improves for most of the extended schemes. The addition of laterally directed cores from the lateral peripheral zone to the mid lobe peripheral zone increases the yield significantly.

Conducted by: Klaus Eichler1, Jennifer Wilby2, Susanne Hempel2, Lindsey Myers2, Jos Kleijnen 2

1. Horten Centre for Patient Oriented Research, University Hospital of Zurich; 2. Centre for Reviews and Dissemination

Publications

Centre for Reviews and Dissemination. Diagnostic value of systematic prostate biopsy methods in the investigation for prostate cancer: a systematic review. CRD Report 29. York: University of York. 2005

Centre for Reviews and Dissemination. A systematic review of prostate cancer biopsy schemes. CRD Report 29 Summary Report. 2005

Eichler K, Hempel S, Wilby J, Myers L, Bachmann L, Kleijnen J. Diagnostic value of systematic biopsy methods in the investigation for prostate cancer: a systematic review. J Urol. 2006;175(5):1605-12

Funding

Commissioned by the NHS Cancer Screening Programmes