Kipnis Pavel, Ramanathan Diya, Hoehn Richard, Jethwa Ashok R, Karakla Daniel W, Rohr Bethany, Sutter Christopher M, Mark Jonathan R, Khaja Sobia F, Li Shawn, Thuener Jason, Carroll Bryan T
Case Western Reserve University School of Medicine, Cleveland, OH, United States.
Department of Otolaryngology - Head & Neck Surgery, University of Wisconsin Hospitals and Clinics, Madison, WI, United States.
Front Oncol. 2024 Nov 13;14:1464767. doi: 10.3389/fonc.2024.1464767. eCollection 2024.
Understanding shared characteristics underlying reported tumor seeding episodes can reveal when tumor seeding is most likely to occur and guide clinical decision making. Our goal was to systematically review tumor seeding across specialties and determine what types of instrumentation and primary tumor histology are associated with tumor seeding.
A systematic review was conducted using PubMed and Web of Science, per PRISMA guidelines. Publications ranged from 1965 to 2022, and studies with five or more reports of seeding were included. Papers were sorted by specialty and assigned a PRISMA Level of Evidence, and data analysis was conducted based on whether each paper supported the clinical significance of seeding.
7,165 papers were screened with 156 papers included for analysis. Overall, there were 8,161 cases of tumors seeding across specialties with the majority from general surgery, gastroenterology, and urology. Laparoscopy (n=1,561) and needle biopsy (n=3,448) were most frequently implicated, and carcinomas (n=5,778) and adenocarcinomas (n=1,090) were the most common primary tumor types.
Upon review of the most updated (2023) versions of the NCCN and NICE guidelines across all cancer types, there were identified gaps in the coverage of tumor seeding within these guidelines, with tumor seeding being entirely absent from certain guidelines and partially absent from others.
Given the high cumulative reports of seeding and the deadly and disseminated nature of secondary disease, it is important to consider seeding risk when manipulating tumors and to modify current cancer care guidelines (NCCN/NICE) to ensure that they appropriately address seeding risk.
了解已报道的肿瘤播散事件背后的共同特征，可揭示肿瘤播散最可能发生的时间，并指导临床决策。我们的目标是系统回顾各专业领域的肿瘤播散情况，并确定哪些类型的器械操作和原发性肿瘤组织学与肿瘤播散相关。
根据PRISMA指南，使用PubMed和Web of Science进行系统回顾。纳入1965年至2022年发表的文献，以及有五例或更多播散报告的研究。论文按专业分类，并赋予PRISMA证据等级，数据分析基于每篇论文是否支持播散的临床意义。
共筛选7165篇论文，其中156篇纳入分析。总体而言，各专业领域共有8161例肿瘤播散病例，大多数来自普通外科、胃肠病学和泌尿外科。腹腔镜检查（n = 1561）和穿刺活检（n = 3448）最常涉及，癌（n = 5778）和腺癌（n = 1090）是最常见的原发性肿瘤类型。
在查阅所有癌症类型的最新（2023年）版NCCN和NICE指南时，发现这些指南在肿瘤播散的覆盖范围上存在空白，某些指南完全未提及肿瘤播散，其他指南则部分缺失。
鉴于播散的累计报告数量众多，以及继发性疾病的致命性和播散性，在处理肿瘤时考虑播散风险并修改当前癌症护理指南（NCCN/NICE）以确保其适当应对播散风险非常重要。
