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Needle tract seeding following core biopsies in retroperitoneal sarcoma
W J Van Houdt1, A M Schrijver2, R B Cohen-Hallaleh3
1Sarcoma Unit, Department of Surgery, The Royal Marsden Hospital, London, UK; Department of Surgical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
Summary
The risk of needle tract recurrence from core needle biopsies in retroperitoneal sarcomas is low but not zero. A trans-retroperitoneal approach with a co-axial technique appears safest, with no impact on local recurrence rates.
Area of Science:
- Oncology
- Surgical Pathology
- Diagnostic Imaging
Background:
- Retroperitoneal tumors frequently necessitate preoperative core needle biopsy for diagnosis.
- Limited data exists on biopsy risks, specifically needle tract or local recurrences, in retroperitoneal sarcomas.
Purpose of the Study:
- To assess the risks associated with core needle biopsies in primary retroperitoneal sarcomas.
- To identify potential for needle tract recurrences and local recurrences following biopsy.
Main Methods:
- Retrospective analysis of 498 patients with primary retroperitoneal sarcoma undergoing resection (1990-2014).
- Examination of patient demographics, tumor characteristics, and biopsy techniques.
- Primary endpoints: needle tract recurrence and local intra-abdominal recurrence.
Main Results:
- 255 of 498 patients had preoperative biopsies; 5 (2%) developed biopsy site recurrence (3 leiomyosarcomas, 2 dedifferentiated liposarcomas).
- All biopsy site recurrences followed trans-abdominal biopsies without a co-axial technique.
- No significant difference in local recurrence rates between biopsied and non-biopsied patients (p=0.30).
Conclusions:
- Core needle biopsy for retroperitoneal sarcoma carries a low, though non-zero, risk of needle tract metastasis.
- Trans-retroperitoneal approach with a co-axial technique appears to be the safest biopsy method.
- Core needle biopsy does not alter the local recurrence rate of retroperitoneal sarcomas.
