Early and Late Complications of Percutaneous Core Needle Biopsy of Retroperitoneal Tumors at Two Tertiary Sarcoma Centers

Berger-Richardson, David; Burtenshaw, Sally M.; Ibrahim, Andrea Marie; Gladdy, Rebecca A.; Auer, R; Beecroft, R.; Dickson, Brendan C.; Purgina, Bibianna; Ambacher, Kristin; Nessim, Carolyn; Swallow, Carol J.

doi:10.1245/s10434-019-07656-6

Cited by 34 publications

(24 citation statements)

References 32 publications

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“…It is a prerequisite to consider the location of the needle trajectory when planning CNB, although this might not be essential for patients with retroperitoneal STS because surgical resection of retroperitoneal STS typically is accomplished transperitoneally, leaving the needle tract in situ. It is interesting to note that a recent large cohort study depicted an incidence of needle tract metastasis of 0.5% in patients with retroperitoneal STS after a median follow‐up of 44 months . Another recent study comparing needle tract resection in patients with extremity STS found no significant difference with regard to recurrence rates compared with patients without needle tract excision .…”

Section: Discussionmentioning

confidence: 97%

Core needle biopsy versus incisional biopsy for differentiation of soft‐tissue sarcomas: A systematic review and meta‐analysis

Birgin

Yang

Hetjens

et al. 2020

Cancer

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BACKGROUND: Controversies exist regarding the biopsy technique of choice for the accurate diagnosis of soft-tissue sarcoma (STS). The objective of this systematic review and meta-analysis was to compare the diagnostic accuracy of core needle biopsy (CNB) versus incisional biopsy (IB) in STS with reference to the final histopathological result. METHODS: Studies regarding the diagnostic accuracy of CNB and IB in detecting STS were searched systematically in the MEDLINE and EMBASE databases. Estimates of sensitivity and specificity with associated 95% CIs for diagnostic accuracy were calculated. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies version 2 (QUADAS-2). RESULTS: A total of 17 studies comprising 2680 patients who underwent 1582 CNBs and 241 IBs with subsequent tumor resection met the inclusion criteria. The sensitivity and specificity of CNB and IB to detect the dignity of lesions were 97% (95% CI, 95%-98%) and 99% (95% CI, 97%-99%), respectively, and 96% (95% CI, 92%-99%) and 100% (95% CI, 94%-100%), respectively. Estimates of the sensitivity and specificity of CNB and IB to detect the STS histotype were 88% (95% CI, 86%-90%) and 77% (95% CI, 72%-81%), respectively, and 93% (95% CI, 87%-97%) and 65% (95% CI, 49%-78%), respectively. Patients who underwent CNB had a significantly reduced risk of complications compared with patients who underwent IB (risk ratio, 0.14; 95% CI, 0.03-0.56 [P ≤ .01). Quality assessment of studies revealed a high risk of bias. CONCLUSIONS: CNB has high accuracy in diagnosing the dignity of lesions and STS histotype in patients with suspected STS with fewer complications compared with IB. Therefore, CNB should be regarded as the primary biopsy technique.

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Section: Discussionmentioning

confidence: 97%

Core needle biopsy versus incisional biopsy for differentiation of soft‐tissue sarcomas: A systematic review and meta‐analysis

Birgin

Yang

Hetjens

et al. 2020

Cancer

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“…Iatrogenic injuries during biopsy procedures of these tumors can also be the cause of hemorrhage. 29 Spontaneous RPB is somewhat rare but has potentially high mortality rates of up to 20%. 30 Vascular bleeding can be arterial or venous.…”

Section: Discussionmentioning

confidence: 99%

Novel Experimental Technique to Create Size-Controlled Retroperitoneal Bleeding in the Infrarenal Aorta of Anesthetized Pigs

Pirouzram

Hamam

Wallin

et al. 2021

Innovations�(Phila)

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Objective Rupture of abdominal aortic aneurysm (rAAA) with a contained retroperitoneal hematoma is potentially fatal. Physiological studies are difficult to perform in patients suffering from life-threatening conditions such as rAAA. A translational model of the condition is therefore needed. The aim was to develop and validate an endovascular animal model for retroperitoneal bleeding of the abdominal aorta with contained hematoma. Methods In anesthetized pigs, a puncture hole was made in the posterolateral portion of the infrarenal aorta by an Outback re-entry catheter device. The hole was gradually enlarged using angioplasty balloons to a specific diameter of either 4 mm ( n = 6), 6 mm ( n = 7), or 8 mm ( n = 6). Onset of bleeding was verified by angiography and macroscopically examined on completion of the experiments. Survival up to 180 min was the primary outcome. Hemodynamic and metabolic markers in arterial blood were secondary outcomes. Results Aortic injury with a contained retroperitoneal hematoma was achieved in all animals. Survival rate at 180 min after onset of bleeding was higher in the 4 mm group compared to the 6 mm ( P = 0.021) and 8 mm groups ( P = 0.002), but not when comparing the 6 mm and 8 mm groups. Systemic hypotension, arterial acidosis, and lactatemia were provoked in the 6 mm and 8 mm groups but not in the 4 mm group. Conclusions A porcine model for a controlled contained left posterolateral retroperitoneal bleeding was created using endovascular methods and validated. This model makes it possible to study the pathophysiology of a retroperitoneal hematoma.

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“…However, such risks are overall quite low, especially while using the coaxial technique. Complications of RPB are reported at 3.1%, of which the majority were intra-tumoral hemorrhage [ 48 ]. The range of NTS has been reported as being between 0.37 and 2% in retrospective reviews of major international sarcoma centers [ 48 , 49 , 50 ].…”

Section: Percutaneous Biopsymentioning

confidence: 99%

“…Complications of RPB are reported at 3.1%, of which the majority were intra-tumoral hemorrhage [ 48 ]. The range of NTS has been reported as being between 0.37 and 2% in retrospective reviews of major international sarcoma centers [ 48 , 49 , 50 ]. In addition, RPB overall does not influence the oncologic outcome, notably overall survival [ 51 , 52 ].…”

Section: Percutaneous Biopsymentioning

confidence: 99%

Retroperitoneal Sarcoma Care in 2021

Schmitz

Nessim

2022

Cancers

Self Cite

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Soft-tissue sarcomas are biologically heterogenous tumors arising from connective tissues with over 100 subtypes. Although sarcomas account for <1% of all adult malignancies, retroperitoneal sarcomas are a distinct subgroup accounting for <10% of all sarcomatous tumors. There have been considerable advancements in the understanding and treatment of retroperitoneal sarcoma in the last decade, with standard treatment consisting of upfront primary surgical resection. The evidence surrounding the addition of radiation therapy remains controversial. There remains no standard with regards to systemic therapy, including immunotherapy. Adjunctive therapy remains largely dictated by expert consensus and preferences at individual centers or participation in clinical trials. In this 2021 review, we detail the anatomical boundaries of the retroperitoneum, clinical characteristics, contemporary standard of care and well as recent advancements in retroperitoneal sarcoma care. Ongoing international collaborations are encouraged to advance our understanding of this complex disease.

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Early and Late Complications of Percutaneous Core Needle Biopsy of Retroperitoneal Tumors at Two Tertiary Sarcoma Centers

Cited by 34 publications

References 32 publications

Core needle biopsy versus incisional biopsy for differentiation of soft‐tissue sarcomas: A systematic review and meta‐analysis

Core needle biopsy versus incisional biopsy for differentiation of soft‐tissue sarcomas: A systematic review and meta‐analysis

Novel Experimental Technique to Create Size-Controlled Retroperitoneal Bleeding in the Infrarenal Aorta of Anesthetized Pigs

Retroperitoneal Sarcoma Care in 2021

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