Needle tract recurrence uncommon after core needle biopsy for retroperitoneal sarcoma

WAILEA, Hawaii — The risk for needle tract recurrence after core needle biopsy for retroperitoneal sarcoma appeared low, according to study results presented at Connective Tissue Oncology Society Annual Meeting.

“Biopsy for retroperitoneal masses is recommended to confirm the diagnosis of sarcoma and tailor treatment for specific sarcoma subtypes,” researcher Winan J. van Houdt, MD, PhD, of The Netherlands Cancer Institute in Amsterdam, said during a presentation. “Transretroperitoneal route is preferred, and coaxial technique is advised.”

Patients with retroperitoneal tumors often undergo preoperative core needle biopsy to establish histological diagnosis, but limited data exist regarding the risk of these procedures.

Van Houdt and colleagues sought to establish the risk for needle tract recurrences or local recurrences caused by core needle biopsies.

Researchers used a prospectively maintained database from two tertiary referral centers — Netherlands Cancer Institute in Amsterdam and Royal Marsden Hospital in London — to identify patients who underwent resection for primary retroperitoneal sarcoma between 1990 and 2014.

Exclusion criteria included follow-up time of less than 1 year; desmoid tumors, gastrointestinal stromal tumors or benign disease; and recurrent or residual disease or metastatic disease at progression.

Needle tract recurrence served as the primary endpoint, and local recurrence served as the secondary endpoint.

The analysis included 498 patients (median age, 60 years; range, 16-89; 53% male). The most common histological subtypes were liposarcoma (66%) and leiomyosarcoma (18%). Median tumor size was 23 cm (range, 3-60). Almost all patients (92%) had R0/R1 margins.

Slightly more than half of the cohort (n = 255; 51.2%) underwent preoperative biopsy. The most common biopsy methods were transabdominal (n = 101; 40%) and transretroperitoneal (n = 55; 20%).

Median follow-up was 38 months.

Five patients (2%) developed biopsy site recurrence (leiomyosarcoma, n = 3; dedifferentiated liposarcoma, n = 2). Latency periods ranged from 0.5 to 7 years.

All needle tract recurrences occurred after transabdominal biopsies that were not performed with coaxial technique, van Houdt said.

Van Houdt acknowledged the low number of events; however, results showed noncoaxial technique significantly correlated with a higher needle tract recurrence rate (P = .02) and transabdominal route did not.

Researchers reported no significant difference in intra-abdominal recurrence rate among patients who underwent core needle biopsy and those who did not, nor did they observe significant differences in recurrence rates among those whose biopsies were performed with transabdominal or transretroperitoneal biopsy routes. – by Mark Leiser

For more information:

van Houdt WJ, et al. Abstract 2797875. Presented at: Connective Tissue Oncology Society Annual Meeting; Nov. 8-11, 2017; Maui.

Di sclosure: van Houdt reports no relevant financial disclosures. Please see the abstract for a list of all other researchers’ relevant financial disclosures.