Implantation metastases from gastrointestinal cancer after percutaneous puncture or biliary drainage.

OBJECTIVE

Evaluation of incidence and outcome of implantation metastases after percutaneous fine-needle biopsy or biliary drainage.

DESIGN

Retrospective study.

SETTING

University hospital, Sweden.

SUBJECTS

Eight patients with implantation metastases from gastrointestinal cancers after percutaneous fine-needle biopsy (n = 7) or biliary drainage (n = 1).

MAIN OUTCOME MEASURES

Incidence of implantation metastases, treatment and influence on outcome and survival.

RESULTS

In two out of three patients who had had otherwise radical operations, the implantation metastases meant that the operations were palliative rather than curative. Patients who had had palliative resections of the implantation metastases developed major local complications. One patient is alive with no signs of disease after 106 months, while one is alive with disease 30 months after the diagnosis of the implantation metastases. The remaining patients have died after 6 to 23 months.

CONCLUSION

The incidence of implantation metastases after fine-needle procedures is probably underestimated. There is a slight but definite risk that the procedure may render an otherwise curative resection palliative. Implantation metastases cause local complaints of varying severity and seems to have a tendency to recur locally. We recommend that fine-needle biopsy should be restricted to patients who will truly benefit from a more accurate preoperative diagnosis.