- Transperineal prostate biopsy (TPBx) is better than transrectal prostate biopsy (TRBx) for detecting clinically significant prostate cancer.
- Exceptions are patients age ≥80 years, with PSA levels >20 ng/mL, or with lower prostate volume (PV).
Why this matters
- Understanding the differences between approaches can help reduce repeat biopsies and overtreatment.
- Researchers compared the detection rates of systematic 12-core TPBx vs TRBx, both guided by transrectal ultrasound, in patients with suspected prostate cancer (N=2962).
- Funding: National Natural Science Foundation of China; Shanghai Municipal Health Bureau.
- TPBx detected clinically significant prostate cancer in a higher proportion of patients overall (P<.001>
- TRBx detection rates were higher in patients who:
- Were age ≥80 years: 80.4% vs 56.5% (P=.004).
- Had PSA levels >20.1-100.0 ng/mL: 80.9% vs 69.1% (P=.040).
- Had lower PV:
- multivariable analysis OR, 0.982 (95% CI, 0.973-0.991; P<.001>
- univariable analysis OR, 0.990 (95% CI, 0.983-0.997; P=.004).
- The study was retrospective and limited to patient data from 2 Chinese hospitals.