Department of Orthopaedics and Trauma Surgery, Musculoskeletal University Center Munich (MUM), University Hospital, LMU Munich, 81377, Munich, Germany.
Department of Orthopaedics, Physical Medicine and Rehabilitation, University Hospital, LMU Munich, Marchioninistr. 15, 81377, Munich, Germany.
World J Surg Oncol. 2022 Jan 11;20(1):14. doi: 10.1186/s12957-021-02481-2.
The degree of contamination of healthy tissue with tumor cells during a biopsy in bone or soft tissue sarcomas is clearly dependant on the type of biopsy. Some studies have confirmed a clinically relevant contamination of the biopsy tract after incisional biopsies, as opposed to core-needle biopsies. The aim of our prospective study was to evaluate the risk of local recurrence depending on the biopsy type in extremity and pelvis sarcomas.
We included 162 patients with a minimum follow-up of 6 months after wide resection of extremity sarcomas. All diagnostic and therapeutic procedures were performed at a single, dedicated sarcoma center. The excision of the biopsy tract after an incisional biopsy was performed as a standard with all tumor resections. All patients received their follow-up after the conclusion of therapy at our center by means of regional MRI studies and, at a minimum, CT of the thorax to rule out pulmonary metastatic disease. The aim of the study was the evaluation of the influence of the biopsy type and of several other clinical factors on the rate of local recurrence and on the time of local recurrence-free survival.
One hundred sixty-two patients with bone or soft tissue tumors of the extremities and the pelvis underwent either an incisional or a core-needle biopsy of their tumor, with 70 sarcomas (43.2%) being located in the bone. 84.6% of all biopsies were performed as core-needle biopsies. The median follow-up time was 55.6 months, and 22 patients (13.6%) developed a local recurrence after a median time of 22.4 months. There were no significant differences between incisional and core-needle biopsy regarding the risk of local recurrence in our subgroup analysis with differentiation by kind of tissue, grading of the sarcoma, and perioperative multimodal therapy.
In a large and homogenous cohort of extremity and pelvic sarcomas, we did not find significant differences between the groups of incisional and core-needle biopsy regarding the risk of local recurrence. The excision of the biopsy tract after incisional biopsy in the context of the definitive tumor resection seems to be the decisive factor for this result.
在骨或软组织肉瘤的活检中，健康组织受到肿瘤细胞污染的程度显然取决于活检类型。一些研究已经证实，与核心针活检相比，切开活检后活检道存在临床相关的污染。我们的前瞻性研究旨在评估肢体和骨盆肉瘤中活检类型对局部复发风险的影响。
我们纳入了 162 例在广泛切除肢体肉瘤后至少随访 6 个月的患者。所有诊断和治疗程序均在一家专门的肉瘤中心进行。所有肿瘤切除术后，都按照标准对切开活检的活检道进行切除。所有患者在完成治疗后在我们中心进行后续随访，通过区域 MRI 研究，最低限度进行胸部 CT 检查，以排除肺转移疾病。该研究的目的是评估活检类型和其他一些临床因素对局部复发率和局部无复发生存时间的影响。
162 例肢体和骨盆的骨或软组织肿瘤患者行肿瘤切开或核心针活检，其中 70 例肉瘤（43.2%）位于骨。所有活检中，84.6%为核心针活检。中位随访时间为 55.6 个月，22 例患者（13.6%）在中位时间 22.4 个月后发生局部复发。在按组织类型、肉瘤分级和围手术期多模式治疗进行亚组分析时，切开和核心针活检在局部复发风险方面没有显著差异。
在一个大的、同质的肢体和骨盆肉瘤队列中，我们没有发现切开活检组和核心针活检组在局部复发风险方面有显著差异。在明确的肿瘤切除术中切除切开活检的活检道似乎是导致这一结果的决定性因素。
