Can we improve the detection rate of prostate cancer using standard 12-core TRUS-guided prostate biopsy? Focused on the location of prostate biopsy

Background We assessed the effect of biopsy location on the prostate cancer detection and clinically significant prostate cancer. Methods A total of 2774 patients with 12-core prostate transrectal ultrasound-guided prostate biopsy were included for per core analysis. Multivariate Cox regression analysis was performed to evaluate the effect of the location of biopsy on the prostate cancer and clinically significant prostate cancer detection. Results Prostate cancer was found in 775 patients (27.9%) and 576 prostate cancer patients (20.8%) were found to be clinically significant. The core length (P = .043), tumor length (P < .001), and % tumor length (P < .001) were significantly different according to the biopsy location. The detection rates for prostate cancer and clinically significant prostate cancer differed significantly according to the location of biopsy. Multivariate analysis revealed that the apical core was significantly related with increased detection of prostate cancer and clinically significant prostate cancer. The lateral core, in addition to apical core, was found to be significantly related with increased detection rates of prostate cancer and clinically significant prostate cancer in men with prostate-specific antigen <10 ng/mL. Conclusions More in-depth discussions on the location of standard 12-core prostate biopsy are considered necessary. Apical core and lateral core biopsies may be helpful, especially in patients with prostate-specific antigen <10 ng/mL if additional biopsies are planned following findings of no target lesions on imaging studies.