Needle tract seeding following core biopsies in retroperitoneal sarcoma

Publication date: Available online 24 June 2017
Source:European Journal of Surgical Oncology (EJSO)
Author(s): W.J. Van Houdt, A.M. Schrijver, R.B. Cohen-Hallaleh, N. Memos, N. Fotiadis, M.J. Smith, A.J. Hayes, F. Van Coevorden, D.C. Strauss
BackgroundRetroperitoneal tumours often require preoperative core needle biopsy to establish a histological diagnosis. Literature is scarce regarding the risk of biopsies in retroperitoneal sarcomas, so the aim of this study is to identify the potential risks of core needle biopsies causing needle tract recurrences or local recurrences.MethodPatients who underwent resection of a primary retroperitoneal sarcoma between 1990 and 2014 were identified from a prospectively maintained database from two tertiary referral centers. Patient demographics, sarcoma subtypes and grade were examined. The primary endpoint was needle tract recurrence and local intra-abdominal recurrence.Results498 patients were included in the analysis. The most common histological subtypes were liposarcoma (66%) and leiomyosarcoma (18%). Of the 498 patients that underwent resection, 255 patients were diagnosed with a preoperative biopsy. Five patients (2%) developed a biopsy site recurrence, 3 leiomyosarcomas and 2 dedifferentiated liposarcomas. All biopsy site recurrences occurred after transabdominal biopsies and were not performed with a co-axial technique. There was no significant difference in local recurrence rate between the patients with or without a biopsy (=0.30) or for the biopsy route (trans-abdominal or trans-retroperitoneal (p=0.72).ConclusionThe risk of a needle tract metastasis after core needle biopsy for retroperitoneal sarcoma is very low but not zero. The safest method seems a trans-retroperitoneal approach with a co-axial technique.. Local recurrence rate is not altered after doing a core needle biopsy.



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