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Correlation between percutaneous biopsy and final histopathology for retroperitoneal sarcoma: a single-centre study
Rebekah Young1, Hayden Snow1, Shona Hendry2,3
1Department of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
ANZ Journal of Surgery
|February 18, 2020
Summary
Retroperitoneal sarcoma biopsy accuracy is 61%, with lower sensitivity for dedifferentiated liposarcoma. Pre-operative biopsy is crucial but may miss dedifferentiated components, impacting treatment decisions.
Area of Science:
- Oncology
- Pathology
- Surgical Oncology
Background:
- Retroperitoneal sarcomas are rare soft tissue tumors, comprising 10-15% of all soft tissue sarcomas.
- Accurate pre-operative histopathological diagnosis from biopsy is critical for determining patient prognosis and guiding treatment strategies, including surgical extent and neoadjuvant therapies.
Purpose of the Study:
- To evaluate the diagnostic accuracy of percutaneous biopsy in primary retroperitoneal sarcomas.
- To determine the concordance between pre-operative biopsy findings and post-surgical histopathological diagnoses.
Main Methods:
- A case series of 117 patients with primary retroperitoneal sarcomas managed between 2008 and 2019.
- Statistical analysis to correlate histopathology from percutaneous biopsy with surgical excision findings.
- Assessment of diagnostic accuracy for various subtypes, including well-differentiated liposarcoma (WDLPS) and dedifferentiated liposarcoma (DDLPS).
Main Results:
- Overall concordance between biopsy and final histopathology was 61% (κ = 0.57).
- Biopsy sensitivity was highest for WDLPS (85%) and leiomyosarcoma (81%), and lowest for DDLPS (40%).
- PET/CT and fluorescence in situ hybridization (FISH) testing improved overall agreement but did not enhance recognition of dedifferentiated components within WD/DDLPS.
Conclusions:
- Pre-operative biopsy is essential for clinical decision-making in retroperitoneal sarcoma management.
- A notable proportion of WDLPS cases have dedifferentiated components detected upon resection that were missed by initial biopsy, potentially affecting treatment planning.
