Authors' objectives:

The aim of this study was to compare the diagnostic performance of systematic prostate biopsy schemes in men scheduled for biopsy due to suspected prostate cancer.

Authors' results and conclusions: Eighty-seven studies with 20,698 patients were analysed. The standard sextant scheme had a significantly lower cancer yield than most of the more extensive biopsy schemes. Adding laterally directed cores increased the yield significantly, whereas additional transition zone cores did not. Schemes with 18 and more cores of the 5-region pattern showed the highest cancer yield (RPR 1.48; 95%-CI 1.32-1.66). However, the difference in the cancer yield of this scheme to the yield of the 12-core scheme from pattern mid-lobar peripheral zone + lateral peripheral zone (RPR 1.31; 95%-CI 1.25-1.37) and the 10-core scheme of the 5-region pattern (RPR 1.38; 95%-CI 1.08-1.76) was not statistically significant. While some evidence suggests that adverse events for schemes up to 12 cores are similar to those of the sextant pattern, this remains unclear for more extended schemes.

Authors' recommendations: Schemes, which apply additional laterally directed cores, showed a higher cancer yield. It still has to be demonstrated that extended biopsy schemes with a higher cancer yield do lead to a survival benefit due to early cancer detection.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.york.ac.uk/inst/crd/CRD_Reports/crdreport29.pdf

Year Published: 2005

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: England

Organisation Name: University of York

Contact Address: University of York, York, Y01 5DD, United Kingdom. Tel: +44 1904 321040, Fax: +44 1904 321041,

Contact Name: crd@york.ac.uk

Contact Email: crd@york.ac.uk

Copyright: Centre for Reviews and Dissemination