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The following is a summary of “Importance of biopsy sample length for cancer diagnosis during trans-perineal prostate biopsy,” published in the September 2024 issue of Urology by Zhu et al.
Researchers conducted a retrospective study to identify factors determining the minimum biopsy sample length required for accurate cancer diagnosis.
They conducted a retrospective analysis of 1,202 cases undergoing rectal ultrasound-guided trans-perineal prostate biopsy (TPB) with standardized procedures. Logistic regression and propensity score matching addressed group imbalances. ROC curve analysis identified independent factors associated with cancer detection rates and the minimum biopsy sample length for accurate diagnosis.
The results showed that the study included 1,202 cases with a cancer detection rate of 40.02% (481/1,202) from standardized 8–18 needle biopsies conducted between June 2020 and October 2023. Gleason scores were 6 in 164 patients, 7 in 134, 8 in 107, 9 in 67, and 10 in 9, with 65.90% (317/481) achieving clinical significance (International Society of Urological Pathology (ISUP) ≥ 2). Multivariate analysis identified age, prostate-specific antigen (PSA), prostate volume, positive multi-parametric magnetic resonance imaging (mp-MRI), and biopsy sample length as significant factors (P<0.05). The sample length did not correlate with prostate volume (Pearson correlation P=0.069). ROC curve analysis yielded area under the curve (AUC) values of 0.674 and 0.664 before and after propensity score matching, with optimal thresholds of 12.25 mm and 11.00 mm.
Investigators concluded that the independent predictors of cancer detection rate during TPB included age, PSA, prostate volume, positive mp-MRI, and sample length, with a minimum required sample length of 11.00 mm as the most critical indicator affecting puncture quality.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-024-01596-4
