Functional trait trade-offs define plant population stability across different biomes.

Ecological theory posits that temporal stability patterns in plant populations are associated with differences in species' ecological strategies. However, empirical evidence is lacking about which traits, or trade-offs, underlie species stability, especially across different biomes. We compiled a worldwide collection of long-term permanent vegetation records (greater than 7000 plots from 78 datasets) from a large range of habitats which we combined with existing trait databases. We tested whether the observed inter-annual variability in species abundance (coefficient of variation) was related to multiple individual traits. We found that populations with greater leaf dry matter content and seed mass were more stable over time. Despite the variability explained by these traits being low, their effect was consistent across different datasets. Other traits played a significant, albeit weaker, role in species stability, and the inclusion of multi-variate axes or phylogeny did not substantially modify nor improve predictions. These results provide empirical evidence and highlight the relevance of specific ecological trade-offs, i.e. in different resource-use and dispersal strategies, for plant populations stability across multiple biomes. Further research is, however, necessary to integrate and evaluate the role of other specific traits, often not available in databases, and intraspecific trait variability in modulating species stability.

Assessing the levels of intraspecific admixture and interspecific hybridization in Iberian wild goats (Capra pyrenaica).

Iberian wild goats (Capra pyrenaica, also known as Iberian ibex, Spanish ibex, and Spanish wild goat) underwent strong genetic bottlenecks during the 19th and 20th centuries due to overhunting and habitat destruction. From the 1970s to 1990s, augmentation translocations were frequently carried out to restock Iberian wild goat populations (very often with hunting purposes), but they were not systematically planned or recorded. On the other hand, recent data suggest the occurrence of hybridization events between Iberian wild goats and domestic goats (Capra hircus). Augmentation translocations and interspecific hybridization might have contributed to increase the diversity of Iberian wild goats. With the aim of investigating this issue, we have genotyped 118 Iberian wild goats from Tortosa-Beceite, Sierra Nevada, Muela de Cortes, Gredos, Batuecas, and Ordesa and Monte Perdido by using the Goat SNP50 BeadChip (Illumina). The analysis of genotypic data indicated that Iberian wild goat populations are strongly differentiated and display low diversity. Only three Iberian wild goats out from 118 show genomic signatures of mixed ancestry, a result consistent with a scenario in which past augmentation translocations have had a limited impact on the diversity of Iberian wild goats. Besides, we have detected eight Iberian wild goats from Tortosa-Beceite with signs of domestic goat introgression. Although rare, hybridization with domestic goats could become a potential threat to the genetic integrity of Iberian wild goats; hence, measures should be taken to avoid the presence of uncontrolled herds of domestic or feral goats in mountainous areas inhabited by this iconic wild ungulate.

Synchrony matters more than species richness in plant community stability at a global scale.

The stability of ecological communities is critical for the stable provisioning of ecosystem services, such as food and forage production, carbon sequestration, and soil fertility. Greater biodiversity is expected to enhance stability across years by decreasing synchrony among species, but the drivers of stability in nature remain poorly resolved. Our analysis of time series from 79 datasets across the world showed that stability was associated more strongly with the degree of synchrony among dominant species than with species richness. The relatively weak influence of species richness is consistent with theory predicting that the effect of richness on stability weakens when synchrony is higher than expected under random fluctuations, which was the case in most communities. Land management, nutrient addition, and climate change treatments had relatively weak and varying effects on stability, modifying how species richness, synchrony, and stability interact. Our results demonstrate the prevalence of biotic drivers on ecosystem stability, with the potential for environmental drivers to alter the intricate relationship among richness, synchrony, and stability.

Meta-analysis of multidecadal biodiversity trends in Europe.

Local biodiversity trends over time are likely to be decoupled from global trends, as local processes may compensate or counteract global change. We analyze 161 long-term biological time series (15-91 years) collected across Europe, using a comprehensive dataset comprising ~6,200 marine, freshwater and terrestrial taxa. We test whether (i) local long-term biodiversity trends are consistent among biogeoregions, realms and taxonomic groups, and (ii) changes in biodiversity correlate with regional climate and local conditions. Our results reveal that local trends of abundance, richness and diversity differ among biogeoregions, realms and taxonomic groups, demonstrating that biodiversity changes at local scale are often complex and cannot be easily generalized. However, we find increases in richness and abundance with increasing temperature and naturalness as well as a clear spatial pattern in changes in community composition (i.e. temporal taxonomic turnover) in most biogeoregions of Northern and Eastern Europe.

Identifying potential areas of expansion for the endangered brown bear (Ursus arctos) population in the Cantabrian Mountains (NW Spain).

Many large carnivore populations are expanding into human-modified landscapes and the subsequent increase in coexistence between humans and large carnivores may intensify various types of conflicts. A proactive management approach is critical to successful mitigation of such conflicts. The Cantabrian Mountains in Northern Spain are home to the last remaining native brown bear (Ursus arctos) population of the Iberian Peninsula, which is also amongst the most severely threatened European populations, with an important core group residing in the province of Asturias. There are indications that this small population is demographically expanding its range. The identification of the potential areas of brown bear range expansion is crucial to facilitate proactive conservation and management strategies towards promoting a further recovery of this small and isolated population. Here, we used a presence-only based maximum entropy (MaxEnt) approach to model habitat suitability and identify the areas in the Asturian portion of the Cantabrian Mountains that are likely to be occupied in the future by this endangered brown bear population following its range expansion. We used different spatial scales to identify brown bear range suitability according to different environmental, topographic, climatic and human impact variables. Our models mainly show that: (1) 4977 km2 are still available as suitable areas for bear range expansion, which represents nearly half of the territory of Asturias; (2) most of the suitable areas in the western part of the province are already occupied (77% of identified areas, 2820 km2), 41.4% of them occurring inside protected areas, which leaves relatively limited good areas for further expansion in this part of the province, although there might be more suitable areas in surrounding provinces; and (3) in the eastern sector of the Asturian Cantabrian Mountains, 62% (2155 km2) of the land was classified as suitable, and this part of the province hosts 44.3% of the total area identified as suitable areas for range expansion. Our results further highlight the importance of increasing: (a) the connectivity between the currently occupied western part of Asturias and the areas of potential range expansion in the eastern parts of the province; and (b) the protection of the eastern sector of the Cantabrian Mountains, where most of the future population expansion may be expected.

Valoración patológica del cáncer de próstata. Nuevos problemas / Pathological assessment of prostate cancer. New problems

Introducción: Las actuales formas de aproximación al diagnóstico y tratamiento del cáncer de próstata obliga al patólogo a un nuevo enfoque de las biopsias para proporcionar los datos exigidos por las nuevas formas de terapia. Discusión: Se explican los nuevos criterios de valoración del sistema de Gleason con la redefinición de los patrones histológicos y los grados malignidad, la incorporación de los denominados grupos pronósticos y la valoración de la masa tumoral. Conclusiones: La actualización de los conocimientos patológicos ayuda a mejorar el manejo de los pacientes, sobre todo en los casos de tumor confinado a la próstata, por la posibilidad de su terapia local

Introduction: Currently, the diagnosis and treatment of prostate cancer requires the pathologist to adopt a fresh approach to the interpretation of biopsies in order to provide the data required for the new forms of therapy. Discussion: The new evaluation criteria of the Gleason system are explained, with the redefinition of histological patterns and degree of malignancy, the incorporation of the so-called prognostic groups and the assessment of the tumour mass. Conclusions: Updating of histopathological information helps to improve patient management, especially in cases of tumour confined to the prostate, given the possibility of local therapy

[Pathological assessment of prostate cancer. New problems]. / Valoración patológica del cáncer de próstata. Nuevos problemas.

INTRODUCTION: Currently, the diagnosis and treatment of prostate cancer requires the pathologist to adopt a fresh approach to the interpretation of biopsies in order to provide the data required for the new forms of therapy. DISCUSSION: The new evaluation criteria of the Gleason system are explained, with the redefinition of histological patterns and degree of malignancy, the incorporation of the so-called prognostic groups and the assessment of the tumour mass. CONCLUSIONS: Updating of histopathological information helps to improve patient management, especially in cases of tumour confined to the prostate, given the possibility of local therapy.

Actualización del sistema Gleason y de otros datos patológicos pronósticos en el cáncer prostático: carga tumoral / Update of the Gleason system and other prognostic pathological data in prostate cancer: Tumor load

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Factors Affecting Diet Variation in the Pyrenean Rock Ptarmigan (Lagopus muta pyrenaica): Conservation Implications.

The Pyrenean rock ptarmigan (Lagopus muta pyrenaica) lives at one of the southernmost limits of the ptarmigan range. Their small population sizes and the impacts of global changes are limiting factors in the conservation of this threatened subspecies. An effective conservation policy requires precise basic knowledge of a species' food and habitat requirements, information that is practically non-existent for this Pyrenean population. Here, we describe the diet of a ptarmigan population in the Eastern Pyrenees, the environmental factors influencing its variability and the relationship between diet floristic composition and quality. Diet composition was determined by microhistological analysis of faeces and diet quality was estimated from free-urate faecal N content. Our results show that grouse diet is based mainly on arctic-alpine shrubs of the Ericaceae family, as well as dwarf willows (Salix spp.) and Dryas octopetala. The most frequently consumed plant species was Rhododendron ferrugineum, but its abundance in the diet was negatively related to the diet nitrogen content. Conversely, the abundance of Salix spp., grass leaves and arthropods increased the nitrogen content of the diet. Seasonality associated with snow-melting contributed the most to variability in the Pyrenean ptarmigan diet, differentiating winter from spring/summer diets. The latter was characterised by a high consumption of dwarf willows, flowers, arthropods and tender forb leaves. Geographic area and sex-age class influenced diet variability to a lesser extent. Current temperature increases in the Pyrenees due to global warming may reduce the persistence and surface area of snow-packs where preferred plants for rock ptarmigan usually grow, thus reducing food availability. The high consumption of Rh. ferrugineum characterised the diet of the Pyrenean population. Given the toxicity of this plant for most herbivores, its potential negative effect on Pyrenean ptarmigan populations should be evaluated.

Influence of Snowmelt Timing on the Diet Quality of Pyrenean Rock Ptarmigan (Lagopus muta pyrenaica): Implications for Reproductive Success.

The Pyrenean rock ptarmigan (Lagopus muta pyrenaica) is the southernmost subspecies of the species in Europe and is considered threatened as a consequence of changes in landscape, human pressure, climate change, and low genetic diversity. Previous studies have shown a relationship between the date of snowmelt and reproductive success in the Pyrenean ptarmigan. It is well established that birds laying early in the breeding season have higher reproductive success, but the specific mechanism for this relationship is debated. We present an explicative model of the relationship between snowmelt date and breeding success mediated by food quality for grouse in alpine environments. From microhistological analyses of 121 faecal samples collected during three years in the Canigou Massif (Eastern Pyrenees), and the assessment of the chemical composition of the main dietary components, we estimated the potential quality of individual diets. Potential dietary quality was correlated with free-urate faecal N, a proxy of the digestible protein content ingested by ptarmigan, and both were correlated with phenological stage of consumed plants, which in turn depends on snowmelt date. Our findings suggest that the average snowmelt date is subject to a strong interannual variability influencing laying date. In years of early snowmelt, hens benefit from a longer period of high quality food resources potentially leading to a higher breeding success. On the contrary, in years of late snowmelt, hens begin their breeding period in poorer nutrient condition because the peaks of protein content of their main food items are delayed with respect to laying date, hence reducing breeding performance. We discuss the possible mismatch between breeding and snowmelt timing.

[Update of the Gleason system and other prognostic pathological data in prostate cancer: Tumor load.] / Actualización del sistema Gleason y de otros datos patológicos pronósticos en el cáncer prostático: carga tumoral.

Desde que D. F. Gleason creara su sistema en 1966 (1 ) y que él mismo modificó en 1974 (2), su método ha sido universalmente aceptado y recomendado por la OMS (3)como factor pronóstico del carcinoma prostático (CaP). Pero, la generalización de la prueba del PSA a partir de 1979 (4), del desarrollo de la TRUS (5) y de la "biopty-gun" para la toma de biopsias en sextantes en los años 80 (6), y sus posteriores modificaciones, son hechos que han cambiado paulatinamente la postura ante el CaP y, con la experiencia adquirida, algunas de las reglas iniciales de Gleason han evolucionado. Aunque se publicaron varios estudios que proponían cambios en el sistema (7), solo los de la ISUP de 2005 (8), han tenido trascendencia real. En ellos se reconsideran algunos de los criterios para identificar aquellos tumores con un patrón histolgico de alto grado (patrón 4 o 5), redefiniendo estos patrones del sistema Gleason.

Embolic myocardial infarction diagnosed with Fourier domain optical coherence tomography.

We report the case of a young female with embolic myocardial infarction. The embolic etiology was confirmed by Fourier Domain Optical Coherence Tomography as well as histo-pathology.

Segunda opinión en Patología / No disponible

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Cáncer de próstata: sobretratamiento y sobrediagnóstico / Prostatic cancer: overtreatment and overdiagnosis

Desde la popularización del test sérico del PSA, la incidencia del diagnóstico del cáncer de próstata y su detección como enfermedad órgano-confinada han aumentado significativamente, disminuyendo, solo ligeramente, su tasa de mortalidad. La evidencia de que la mayoría de los varones con cáncer prostático diagnosticado en un screening de PSA mueren por diferente causa a su enfermedad ha condicionado los conceptos de sobretratamiento y sobrediagnóstico del mismo. El patólogo, que realiza el diagnóstico, tiene la responsabilidad de no sobrediagnosticar el cáncer, extremando su prudencia ante los focos tumorales minúsculos (en nuestra serie, el 8,57% de los tumores ocupaban menos del 3% del total del tejido de la biopsia) y los cambios histológicos de valoración dudosa, especialmente los de ASAP (AGF), así como los patrones tumorales 1 y 2 de Gleason que, en nuestra opinión (tras el estudio de más de 9.000 casos), son de difícil o imposible valoración en los cilindros de biopsia. Y el urólogo debe hacer una interpretación clínica de esos mínimos tumores, o de las lesiones sospechosas, en conjunción con las condiciones clínicas de los pacientes antes de establecer una actitud terapéutica, evitando el sobretratamiento

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[Transrectal ultrasound-guided prostatic biopsy: contribution of an ultrasound diagnostic unit after ten years of experience]. / Biopsia transrectal ecodirigida de próstata: aportación de una unidad urológica de diagnóstico ecográfico tras 10 años de experiencia.

OBJECTIVES: Although transrectal ultrasound-guided (TRUS) prostatic biopsy is the procedure of choice for the diagnosis of prostate cancer (PC), neither the ideal number of cores nor the number of repeated biopsies, nor the required diagnostic yield have been established. After our experience of ten years with TRUS biopsy we perform a review of the technique and its indications. METHODS: PSA, ultrasound features, and pathologic data of 6000 patients undergoing modified sextant TRUS biopsy between 1994 to December 2002 were collected. 222 patients undergoing ten-core TRUS biopsy were included in an experimental group to study the role of the extended biopsy. The contribution of the extra cores to the diagnostic yield in the experimental group was studied to determine the effectiveness of the extended biopsy, using as a control group 552 patients undergoing sextant TRUS biopsy during 2002. Both groups were comparable for the study variables at the start of the study. RESULTS: The incidence of PC in the first biopsy in the group of 6000 patients was 39.1% (2345/6000). Patients with PSA between 4 and 10 ng/ml have an incidence of PC greater than 50% among prostates smaller than 20 cc, diminishing down to 8.9% in those greater than 50 cc. The percentage of PC among patients with negative digital rectal examination (DRE), normal TRUS, and PSA below 4 ng/ml was 16.7%. The diagnostic yield for PSA density lower than 0.11 ng/ml/cc was lower than 8%. The free/total PSA ratio shows a 13.7% incidence of PC with values higher than 0.24. Multivariate logistic regression analysis showed that the only non-significant parameter was free/total PSA. Sixty (27.15%) patients of the extended TRUS biopsy group had PC. Only 2.25% of the 221 patients benefited from the augmented number of biopsies. There were no significant differences in the figures of prostate cancer between groups. Only PSA and volume where significant in the multivariate logistic regression analysis; number of samples, PSA density and age lacked of influence in the detection of PC. CONCLUSIONS: The sextant biopsy model obtaining cores from the lateral horns of the prostate continues to be the reference for TRUS biopsy, and the extended biopsy is not applicable to all patients from the beginning do to the small increase in the diagnostic yield. Isolated PSA may not be the unique reference to indicate TRUS biopsy, being volume, in our experience, a definitive factor for the adjustment of high risk levels.

Biopsia transrectal ecodirigida de próstata: aportación de una unidad urológica de diagnóstico exográfico tras 10 años de experiencia / Transrectal ultrasound-guided prostatic biopsy: contribution of an ultrasound diagnostic unit after ten years of experience

OBJETIVO: A pesar de que la Biopsia Transrectal Ecodirigida (BTE) prostática es el método fundamental de diagnóstico del cáncer prostático (CP) no se ha establecido el número ideal de muestras, de repeticiones o la rentabilidad que se le debe exigir. A través de la experiencia de 10 años en BTE pretendemos revisar que puede aportarse a la realización de la prueba y a sus indicaciones. MÉTODO: Se han recogido los datos de PSA, características ecográficas y anatomía patológica de 6000 pacientes a los que se realizó BTE sextante modificada desde 1994 a diciembre de 2002.Para estudiar el papel de la biopsia ampliada se realizo un grupo experimental de 222 pacientes en los que se intentó la obtención de 10 muestras prostáticas mediante BTE. Para determinar la rentabilidad de la biopsia ampliada se estudiará la aportación de las muestras “extras” al rendimiento diagnóstico del grupo experimental (BTE ampliada) y se empleará como grupo control (BTE sextante) y de comparación un conjunto más amplio de 552 pacientes biopsiados en el año 2002. Se estudió la comparabilidad del grupo experimental y control, respecto a las variables recogidas al inicio del estudio. RESULTADOS: La incidencia de CP en el grupo de 6000 pacientes en la primera biopsia es del 39,1% (2345/6000). Los pacientes con PSA entre 4 y 10 ng/ml presentan una incidencia mayor del 50% de cánceres entre las próstatas de menos de 20 cc que disminuye hasta un 8,9% en la mayores de 50 cc. El porcentaje de CP entre los pacientes con PSA menor de 4ng/ml con tacto y ETR normales fue del 16,7%. La rentabilidad con Densidad de PSA menor de 0,11 ng/ml/c.c. fue inferior al 8%. El PSA L/T muestra una incidencia de CP del 13,7% con cifras superiores a 0,24. En las regresiones logísticas multivariantes únicamente el PSA L/T no resultó significativo. Entre los pacientes a los que se realizó BTE ampliada 60 (27,15%) presentaron CP. Tan sólo el 2,25% del total de 221 pacientes se beneficiaron del mayor número de muestras. No se han encontrado diferencias significativas en las cifras de CP entre los grupos de biopsia sextante y ampliada. En el análisis de regresión logística multivariante únicamente el PSA y el volumen han resultado significativos, careciendo de influencia en la detección de cáncer el número de muestras, la DPSA y la edad. CONCLUSIONES: El modelo sextante con obtención de muestras de los cuernos laterales de la próstata sigue siendo la referencia de la BTE mientras que la BTE ampliada no es aplicable de inicio a todos los pacientes por el escaso incremento en la capacidad diagnóstica. El PSA aislado no puede ser más el referente único para indicar la BTE, siendo, en nuestra experiencia, el volumen un factor decisivo para el ajuste de los niveles de mayor riesgo

OBJECTIVES: Although transrectal ultrasound- guided (TRUS) prostatic biopsy is the procedure of choice for the diagnosis of prostate cancer (PC), neither the ideal number of cores nor the number of repeated biopsies, nor the required diagnostic yield have been established. After our experience of ten years with TRUS biopsy we perform a review of the technique and its indications. METHODS: PSA, ultrasound features, and pathologic data of 6000 patients undergoing modified sextant TRUS biopsy between 1994 to December 2002 were collected. 222 patients undergoing ten-core TRUS biopsy were included in an experimental group to study the role of the extended biopsy. The contribution of the extra cores to the diagnostic yield in the experimental group was studied to determine the effectiveness of the extended biopsy, using as a control group 552 patients undergoing sextant TRUS biopsy during 2002. Both groups were comparable for the study variables at the start of the study. RESULTS: The incidence of PC in the first biopsy in the group of 6000 patients was 39.1% (2345/6000). Patients with PSA between 4 and 10 ng/ml have an incidence of PC greater than 50% among prostates smaller than 20 cc, diminishing down to 8.9% in those greater than 50 cc. The percentage of PC among patients with negative digital rectal examination (DRE), normal TRUS, and PSA below 4 ng/ml was 16.7%. The diagnostic yield for PSA density lower than 0.11 ng/ml/cc was lower than 8%. The free/total PSA ratio shows a 13.7% incidence of PC with values higher than 0.24. Multivariate logistic regression analysis showed that the only non-significant parameter was free/total PSA. Sixty (27.15%) patients of the extended TRUS biopsy group had PC. Only 2.25% of the 221 patients benefited from the augmented number of biopsies. There were no significant differences in the figures of prostate cancer between groups. Only PSA and volume where significant in the multivariate logistic regression analysis; number of samples, PSA density and age lacked of influence in the detection of PC. CONCLUSIONS: The sextant biopsy model obtaining cores from the lateral horns of the prostate continues to be the reference for TRUS biopsy, and the extended biopsy is not applicable to all patients from the beginning do to the small increase in the diagnostic yield. Isolated PSA may not be the unique reference to indicate TRUS biopsy, being volume, in our experience, a definitive factor for the adjustment of high risk levels

[Diagnostic yield of the extended prostatic biopsy with 10 cores. Prospective study on 222 patients]. / Rentabilidad de la biopsia ampliada con 10 muestras prostáticas. estudio prospectivo sobre 222 pacientes.

OBJECTIVES: The number of biopsy samples for a proper prostate cancer diagnosis has not yet been established. We report our experience with the 10-sample extended biopsy. METHODS: We collected the results of a group of 222 patients undergoing extended ultrasound guided prostate biopsy with 10 samples. In addition to the sextant biopsies 2 extra samples were obtained from the dorsal-apex area on each lobe. Results of this group were compared with a control group of 552 patients undergoing sextant biopsy in 2002 with the same inclusion in criteria. RESULTS: 60 patients had cancer (27.15%). The extra samples gave the diagnosis in 5 out of 60 patients, 8.33% of the tumors and 2.25% of all patients. Control group showed cancer in 24.5%, not having the difference statistical significance. The incidence in prostates smaller than 20 cc was 69.2%, 11.6% in prostates bigger than 50 cc. 80% of the patients with prostate cancer only in the extra samples have a volume smaller than 35 cc. Multivariate logistic regression study for the probability of prostate cancer only showed association with serum PSA and prostate volume but not with the number of samples. CONCLUSIONS: The extended biopsy is not indicated as an initial diagnostic technique, being reserved for specific cases such as repeated biopsies in patients with high risk pathology reports. Neither it is indicated in the bigger volume prostates.

Rentabilidad de la biopsia ampliada con 10 muestras prostáticas. Estudio prospectivo sobre 222 pacientes / Diagnostic yield of the extended prostatic biopsy with 10 cores. Prospective study on 222 patients

OBJETIVO: Actualmente no está establecidoni el número de muestras ni de biopsias para el correcto diagnóstico del cáncer prostático. Presentamos nuestra experiencia en biopsia ampliada con 10 muestras.MÉTODO: se recogieron los resultados de un grupo de 222 pacientes en los que se realizó biopsia transrectal ecodirigida prostática ampliada con 10 muestras. Ademásde las muestras de una biopsia sextante se obtuvieron2 muestras “extras” de la región apical-dorsal de cada lóbulo, estudiando los resultados en este grupo y comparándolo con un grupo control de 552 pacientes sometidos en 2002 a biopsia sextante con los mismos criterios de inclusión.RESULTADOS: Presentaron cáncer 60 pacientes (27,15%). Las muestras “extras” supusieron el diagnósticoen 5 de los 60 pacientes, el 8,33% de los tumores y el 2,25% del total de pacientes. El grupo de control presentabacáncer en un 24,5% no resultando significativa la diferencia. Mientras que la incidencia en próstatas menores de 20 cc fue del 69,2% en las mayores de 50cc fue del 11,6%. De los pacientes diagnosticados únicamente por las muestras “extras” el 80% tenía un volumen menor de 35cc. En el estudio de regresión logísticamultivariante sólo se asoció con la posibilidad de cáncer el PSA sérico y el volumen prostático pero no el número de muestras.CONCLUSIÓN: la biopsia ampliada no está indicada como técnica diagnóstica de inicio debiendo reservarsepara casos concretos como rebiopsias en pacientes con anatomías patológicas de alto riesgo. Tampoco parece indicada en la biopsia de próstatas de mayor tamaño

OBJECTIVES: The number of biopsy samples for a proper prostate cancer diagnosis has not yet been established. We report our experience with the10-sample extended biopsy.METHODS: We collected the results of a group of 222 patients undergoing extended ultrasound guided prostate biopsy with 10 samples. In addition to the sextant biopsies 2 extra samples were obtained from the dorsal-apex area on each lobe. Results of this group were compared with a control group of 552 patients undergoing sextant biopsy in 2002 with the same inclusion in criteria.RESULTS: 60 patients had cancer (27.15%). The extra samples gave the diagnosis in 5 out of 60 patients, 8.33% of the tumors and 2.25% of all patients. Control group showed cancer in 24.5%, not having the difference statistical significance. The incidence in prostates smaller than 20 cc was 69.2%, 11.6% in prostates bigger than 50 cc. 80% of the patients with prostate cancer only in the extra samples have a volume smaller than 35 cc. Multivariate logistic regression study for the probability of prostate cancer only showed association with serum PSA and prostate volume but not with the number of samples.CONCLUSIONS: The extended biopsy is not indicated as an initial diagnostic technique, being reserved for specific cases such as repeated biopsies in patients with high risk pathology reports. Neither it is indicated in the bigger volume prostates