Pediatric Bone Sarcoma Biopsy Tract Excision: Is it Safe to Resect Separately?

Area of Science:

• Pediatric Oncology
• Surgical Oncology
• Diagnostic Pathology

Background:

• Biopsy is crucial for pediatric bone sarcoma diagnosis, influencing treatment and prognosis.
• Traditional practice involved resecting the biopsy tract with the tumor due to contamination concerns.
• This approach can complicate surgical planning and increase patient morbidity.

Purpose of the Study:

• To compare oncologic outcomes between open and closed biopsy techniques in pediatric bone sarcomas.
• To evaluate the impact of biopsy tract resection (with or separate from the tumor) on outcomes.
• To inform surgical planning and management strategies for pediatric bone sarcomas.

Main Methods:

• Retrospective review of 73 pediatric bone sarcoma patients (2006-2021).
• Analysis of biopsy techniques (open vs. closed) and resection methods (tract with tumor vs. separate).
• Statistical comparison of local recurrence, disease-free survival, metastatic progression, and overall survival.

Main Results:

• 73 patients included: 48 open biopsies and 25 closed biopsies (23 core needle, 2 fine needle aspiration).
• Biopsy tract resection was performed with the main tumor in 49.3% and separately in 50.7%.
• No significant differences were found in local recurrence, survival, or metastatic progression between biopsy methods or resection strategies.

Conclusions:

• Both open and closed biopsy techniques are safe for pediatric bone sarcoma diagnosis with low seeding rates.
• Biopsy tract resection method (with or separate from tumor) does not impact oncologic outcomes.
• Surgical planning should prioritize patient, tumor, and institutional factors over biopsy technique or tract management.