Wilkinson M J, Martin J L, Khan A A, Hayes A J, Thomas J M, Strauss D C
Sarcoma Unit, Department of Surgery, Royal Marsden NHS Foundation Trust, London, UK.
Ann Surg Oncol. 2015 Mar;22(3):853-8. doi: 10.1245/s10434-014-4059-x. Epub 2014 Sep 5.
Tumours within the retroperitoneum can cause a diagnostic dilemma. A preoperative core needle biopsy often is required to establish a histological diagnosis. Preoperative core needle biopsy for extremity soft-tissue sarcoma is oncologically safe and biopsy site recurrence is extremely rare, attributed to placing the biopsy site within the planned resection field. This study investigates whether preoperative core needle biopsy affects oncological outcomes in retroperitoneal sarcomas.
Patients undergoing resection of intermediate- and high-grade primary retroperitoneal sarcoma from 1990 until 2011 were included. Primary endpoints were immediate biopsy-related complications, local recurrence, and overall survival.
A total of 150 patients were included in the analysis. Of these, 90 patients underwent resection after a preoperative biopsy. Median follow-up was 48 months. One patient required hospital admission postbiopsy for an abdominal wall rectus sheath haematoma. No patient developed intra-abdominal complications that required hospitalisation or early operation related to core needle biopsy. No patient developed a biopsy site recurrence. There was no significant increase in either local recurrence (p = 0.101) or overall survival (p = 0.191) after core needle biopsy.
Preoperative core needle biopsy for retroperitoneal sarcomas is safe and does not affect oncological outcome.
腹膜后肿瘤可导致诊断难题。通常需要进行术前粗针穿刺活检以确立组织学诊断。肢体软组织肉瘤的术前粗针穿刺活检在肿瘤学上是安全的,且活检部位复发极为罕见,这归因于将活检部位置于计划切除范围内。本研究调查术前粗针穿刺活检是否会影响腹膜后肉瘤的肿瘤学结局。
纳入1990年至2011年期间接受中、高级别原发性腹膜后肉瘤切除术的患者。主要终点为即时活检相关并发症、局部复发和总生存期。
共有150例患者纳入分析。其中,90例患者在术前活检后接受了切除术。中位随访时间为48个月。1例患者活检后因腹壁直肌鞘血肿需住院治疗。没有患者发生与粗针穿刺活检相关的需要住院或早期手术的腹腔内并发症。没有患者出现活检部位复发。粗针穿刺活检后局部复发(p = 0.101)或总生存期(p = 0.191)均无显著增加。
腹膜后肉瘤的术前粗针穿刺活检是安全的,且不影响肿瘤学结局。