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Prostate Cancer
Volume 2013 (2013), Article ID 705865, 6 pages
Clinical Study

Analysis of Preoperative Detection for Apex Prostate Cancer by Transrectal Biopsy

1Department of Urology, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba 260-8670, Japan
2Division of Urology, Chiba Cancer Center, Chiba 260-8717, Japan
3Department of Urology, Toho University Sakura Medical Center, Sakura 285-8741, Japan
4Department of Pathology, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan

Received 11 November 2012; Accepted 21 January 2013

Academic Editor: Manfred P. Wirth

Copyright © 2013 Tomokazu Sazuka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. The aim of this study was to determine concordance rates for prostatectomy specimens and transrectal needle biopsy samples in various areas of the prostate in order to assess diagnostic accuracy of the transrectal biopsy approach, especially for presurgical detection of cancer in the prostatic apex. Materials and Methods. From 2006 to 2011, 158 patients whose radical prostatectomy specimens had been evaluated were retrospectively enrolled in this study. Concordance rates for histopathology results of prostatectomy specimens and needle biopsy samples were evaluated in 8 prostatic sections (apex, middle, base, and transitional zones bilaterally) from 73 patients diagnosed at this institution, besides factors for detecting apex cancer in total 118 true positive and false negative apex cancers. Results. Prostate cancer was found most frequently (85%) in the apex of all patients. Of 584 histopathology sections, 153 (49%) from all areas were false negatives, as were 45% of apex biopsy samples. No readily available preoperative factors for detecting apex cancer were identified. Conclusions. In Japanese patients, the most frequent location of prostate cancer is in the apex. There is a high false negative rate for transrectal biopsy samples. To improve the detection rate, transperitoneal biopsy or more accurate imaging technology is needed.