Prostate Cancer Prostate Cancer Distribution in Patients Diagnosed by Transperineal Template-Guided Saturation Biopsy Gregory S. Merrick a, *, Sarah Gutman a , Hugo Andreini b , Walter Taubenslag b , David L. Lindert b , Rodney Curtis b , Edward Adamovich c , Richard Anderson a , Zachariah Allen a , Wayne Butler a , Kent Wallner d a Schiffler Cancer Center, Wheeling Hospital and Wheeling Jesuit University, Wheeling, WV, USA b Department of Urology, Wheeling Hospital, Wheeling, WV, USA c Department of Pathology, Wheeling Hospital, Wheeling, WV, USA d Puget Sound Healthcare Corporation, Group Health Cooperative, University of Washington, Seattle, WA, USA european urology 52 (2007) 715–724 available at www.sciencedirect.com journal homepage: www.europeanurology.com Article info Article history: Accepted February 14, 2007 Published online ahead of print on February 23, 2007 Keywords: Prostate cancer Biopsy Transperineal Cancer distribution Abstract Objectives: To determine the prostate cancer incidence, anatomic dis- tribution, Gleason score profile, and tumor burden in patients diagnosed by transperineal template-guided saturation biopsy (TTSB). Materials and methods: One hundred and two patients underwent TTSB; all but one patient had undergone at least one prior negative TRUS biopsy. Criteria for inclusion included an elevated PSA and/or the diag- nosis of ASAP or high-grade PIN on prior biopsy. The prostate gland was divided into 24 regional biopsy locations. The median number of biopsy cores was 50. Multiple clinical parameters were evaluated as predictors for prostate cancer diagnosis. Results: The mean patient age was 64.8 yr with a mean PSA of 9.1 ng/ml and a prostate volume of 78.6 cm 3 . On average, patients had undergone 2.1 prior negative TRUS biopsies with a mean of 22.4 core biopsies. Prostate cancer was diagnosed in 43 patients (42.2%) with a Gleason score distribution of 6–9. No anatomic region of the prostate gland was spared of cancer. In patients with prostate cancer, an average of 9.9 cores were involved. In multivariate analysis, prostate volume was the best predictor for prostate cancer diagnosis. Conclusions: TTBS diagnosed prostate cancer in 42.2% of patients. Con- siderable anatomic variability in prostate cancer distribution was docu- mented. On the basis of this and other reports, cancer eradication will depend on treatment of the entire prostate gland. # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. * Corresponding author. Schiffler Cancer Center, Wheeling Hospital, 1 Medical Park, Wheeling, WV 26003-6300, USA. Tel. +1 304 243 3490; Fax: +1 304 243 5047. E-mail address: gmerrick@urologicresearchinstitute.org (G.S. Merrick). 0302-2838/$ – see back matter # 2007 European Association of Urology. Published by Elsevier B.V. All rights reserved. doi:10.1016/j.eururo.2007.02.041