Advertisement

Commentary RE: The Sextant Protocol for Ultrasound-Guided Core Biopsies of the Prostate Underestimates the Presence of Cancer

      Following the citation trail from this Urology paper from 1997,
      • Norberg M
      • Egevad L
      • Holmberg L
      • Sparén P
      • Norlén BJ
      • Bush C
      The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer.
      it is mainly cited as providing evidence around 2 issues in prostate cancer diagnosis: Targeted biopsies added to systematic biopsies increases the sensitivity; however, a systematic sextant protocol even if combined with targeted biopsies is not sensitive enough to be a satisfactory protocol. Thus, it supports the use of combined protocols and the use of more extensive systematic biopsies than the original sextant mapping, protocols that still are considered to be standard in many guidelines. The longevity of that standard is maybe why the paper still have citations in 2019. One can however foresee that this is history very soon; MRI-based protocols are on their way into guidelines and recommendations.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Urology
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Norberg M
        • Egevad L
        • Holmberg L
        • Sparén P
        • Norlén BJ
        • Bush C
        The sextant protocol for ultrasound-guided core biopsies of the prostate underestimates the presence of cancer.
        Urology. 1997; 50: 562-566
        • Norberg M
        Transrectal ultrasound and core biopsies for the diagnosis of prostate cancer. A study of pretreatment investigation strategy for patients with suspected prostate cancer.
        Acta Radiol Suppl. 1994; 393: 1-21
        • Bill-Axelson A
        • Holmberg L
        • Garmo H
        • et al.
        Radical prostatectomy or watchful waiting in prostate cancer – a 29-year follow-up.
        N Engl J Med. 2018; 379: 2319-2329
        • Kasivisvanathan V
        • Ranniko AS
        • Borhi M
        • et al.
        MRI-targeted or standard biopsy for prostate-cancer diagnosis.
        N Engl J Med. 2018; 378: 1767-1777
        • Wegelin O
        • Exterkate L
        • van der Leest
        • et al.
        The FUTURE trial: a multicenter randomized controlled trial on target biopsy techniques based on magnetic resonance imaging in the diagnosis of prostate cancer in patients with prior negative biopsies.
        Eur Urol. 2019; 75: 582-590
        • Bill-Axelson A
        • Holmberg L
        • Norlén BJ
        • Busch C
        • Norberg M
        No increased prostate cancer incidence after negative transrectal ultrasound-guided multiple biopsies in men with increased prostate specific antigen and/or abnormal digital rectal examination.
        J Urol. 2003; 170: 1180-1183