Tumour seeding following percutaneous needle biopsy: The real story!

Robertson, Elise; Baxter, Grant M.

doi:10.1016/j.crad.2011.05.012

Cited by 171 publications

(118 citation statements)

References 34 publications

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“…The rate of biopsy tract seeding in our series was 12%. There are some published cases of tumor recurrence in the path of no resected or incompletely resected percutaneous and open biopsy tracts [6,9,24,35]. Ribeiro et al [23] reported contamination of 32% of the biopsy tracts in the largest series with 25 bone and soft tissue sarcomas.…”

Section: Discussionmentioning

confidence: 99%

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Barrientos-Ruiz

Ortiz‐Cruz

Serrano-Montilla

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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Background A biopsy is the final step in the diagnosis of sarcomas. Complete resection of the biopsy tract traditionally has been recommended in musculoskeletal oncology guidelines, as that tract is considered potentially seeded with tumor cells. However, to our knowledge, the frequency and implications of contamination of the biopsy tract-specifically with respect to the likelihood of local recurrence-and the factors that affect cell seeding are not well described. Questions/purposes We asked: (1) How often are biopsy tracts contaminated with pathologically detectable tumor cells at the time of tumor resection? (2) What factors, in particular biopsy type (open versus percutaneous), are associated with tumoral seeding? (3) Is biopsy tract contamination associated with local recurrence? Methods This is a retrospective study of a database with patient data collected from a single center between 2000 and 2013. We treated 221 patients with sarcomas. A total of 27 patients (12%) were excluded and 14 (6%) were lost to followup. One hundred eighty patients finally were included in the analysis who either had biopsies at our center (112) or biopsies at outside institutions (68). Of those performed at our center, 15 (13%) were open and 97 (87%) were percutaneous; of those at outside centers, those numbers were 47 (69%) and 21 (31%) respectively. Median followup was 40 months (range, 24-152 months). During the study period, we generally performed percutaneous biopsies as a standard practice for the diagnosis of bone and soft tissue sarcomas and open biopsies were done when the percutaneous procedure failed to provide a histologic characterization. The mean age of the population was 48 years (range, 7-87 years); 60% were male; 42% had bone sarcomas. Nineteen patients had preoperative radiotherapy and 56 had postoperative radiotherapy. Fifty-seven patients received neoadjuvant chemotherapy and 73 had Each author certifies that he or she has no commercial associations (eg, consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research 1 editors and board members are on file with the publication and can be viewed on request. Each author certifies that his or her institution has or waived for the human protocol for this investigation and that all investigations were conducted in conformity with ethical and confidentiality principles of research. This work was performed at the Musculoskeletal Tumor Unit, Orthopaedics and Traumatology Department, at La Paz University Hospital, Madrid, Spain. We determined what proportion of biopsy tracts were contaminated by pathologic analysis of the biopsy tract specimen; during the period in question, our routine practice was to excise the biopsy tract whenever possible at the time of the definitive resection. Using the logistic regression test and Mantel-Haenszel test, we compared open wi...

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Section: Discussionmentioning

confidence: 99%

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Barrientos-Ruiz

Ortiz‐Cruz

Serrano-Montilla

et al. 2017

Clinical Orthopaedics &Amp; Related Research

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“…Core biopsy carries an additional risk of mucosal tumour seeding [16,17] and therefore, when in doubt, and when a conclusive procedure is required, excision biopsy may be the best option. Although lymph node biopsy carries a specific risk of accessory nerve damage when undertaken within the posterior triangle [18,19], this risk is extremely low, and the procedure can be carried out safely and easily under local anaesthetic in the right hands.…”

Section: Discussionmentioning

confidence: 99%

Level 5 Lymphadenopathy Warrants Heightened Suspicion for Clinically Significant Pathology

Cunnane

Cheung

Moore

et al. 2016

Head and Neck Pathol

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We conclude that patients presenting with level 5 lymphadenopathy should be investigated with heightened clinical vigilance. Our results suggest that up to 80 % will harbour clinically significant pathology requiring further medical treatment, three quarters of which will be malignancy. We report an observational study of histological outcomes of level 5 lymph node biopsies from a regional histopathology department across 5 years. 184 subjects were identified as having a biopsy of a lymph node from the level 5 region within the study period. One hundred and fifty six cases (84.8 %) had clinically significant pathology on final histology requiring further medical treatment. Lymphoma accounted for the highest number of cases (n = 72, 39.1 %), followed by metastatic carcinoma (n = 65, 35.3 %) and granulomatous change (n = 17, 9.2 %). Gender and laterality were not shown to be independent predictors of pathology significance (p [ 0.05).

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“…Le suivi de marqueurs génétiques circulants pourrait également permettre d'éviter de multiples interventions chirurgicales ou l'analyse de prélèvements archivés de la tumeur primaire. De plus, les biopsies classiques, souvent difficiles, voire impossibles si la tumeur est inaccessible, peuvent faire courir un risque au patient, et être responsables de la dissémination de la tumeur [15]. L'analyse du sang (biopsie « liquide ») pourrait également être plus représentative de l'état pathologique du patient [16].…”

Section: Caractéristiques De L'adn Libre Circulant Et Contraintes Liéunclassified

PCR digitale en micro-compartiments

et al. 2015

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> La recherche d'altérations génétiques dans les cellules tumorales fait partie de la prise en charge des patients atteints de cancer. L'analyse de l'ADN libre tumoral circulant dans les fluides biologiques, dont le sang, pourrait permettre le dépistage précoce de la maladie, la gestion thérapeutique des patients et la détection de récidives. Cet ADN libre tumoral, décrit comme représentatif de l'hétérogénéité tumorale, peut être retrouvé dans le sang dans des proportions faibles et variables selon la nature et la progression de la tumeur. Son analyse nécessite des méthodes à la fois très sensibles, spécifiques et quantitatives. Ces exigences représentaient une limite technologique que les récentes avancées de la PCR (polymerase chain reaction) digitale devraient permettre de dépasser. < tumeurs à l'échelle moléculaire, sont particulièrement pertinents dans le domaine de la médecine de précision. En effet, de nombreux traitements ciblés ont été développés ces dix dernières années, et de nouveaux marqueurs de sensibilité ou de résistance à ces traitements mis en évidence. Le suivi au cours du temps de ces altérations génétiques permettrait de suivre l'évolution du cancer, l'efficacité d'un traitement ou de détecter une éventuelle récidive. L'utilisation pleinement efficace de ces marqueurs en oncologie clinique nécessite cependant des méthodes précises et fiables pour les détecter dans différents types d'échantillons (biopsies tumorales, fluides biologiques dont le sang). L'avancée technologique récente que représente la PCR (polymerase chain reaction) digitale (dPCR) en microcompartiments permet la détection et la quantification de séquences rares avec une sensibilité et une précision hors de portée des procédures conventionnelles [43] (➜). La dPCR a ainsi récemment émergé comme un outil extrêmement prometteur pour le suivi non invasif de marqueurs géné-tiques, particulièrement pertinent pour la recherche en cancérologie. Caractéristiques de l'ADN libre circulant et contraintes liées à sa mesureDes acides nucléiques sont retrouvés dans l'ensemble des fluides biologiques dont le sang, les urines, les selles, la salive ou le liquide Le développement et la démocratisation des techniques de biologie moléculaire ont permis d'importants progrès dans la détection et l'analyse des acides nucléiques. Ces techniques constituent aujourd'hui un outil clé de la prise en charge des patients atteints de cancer. En effet, des réseaux complexes d'altérations génétiques ont été mis en évidence dans la plupart des cancers. Il peut s'agir, entre autres, de délétions, de mutations ponctuelles, de réarrangements chromosomiques ou d'amplifications. Ces altérations génétiques étant présentes uniquement dans les cellules tumorales, elles représentent des marqueurs spécifiques de cancer. Ces marqueurs peuvent être classés en trois grandes catégories : il peut s'agir de marqueurs diagnostiques, permettant, par exemple, de déterminer la localisation de la maladie ou son stade ; de marqueurs pronostiques, permettant de détecter la progressi...

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Tumour seeding following percutaneous needle biopsy: The real story!

Cited by 171 publications

References 34 publications

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Level 5 Lymphadenopathy Warrants Heightened Suspicion for Clinically Significant Pathology

PCR digitale en micro-compartiments

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