Comparative retrospective study on the modalities of biopsying peripheral neuroblastic tumors: a report from the Italian Pediatric Surgical Oncology Group (GICOP)

Pediatr Blood Cancer. 2017 May;64(5). doi: 10.1002/pbc.26284. Epub 2016 Oct 20.

Abstract

Background: Peripheral neuroblastic tumors are the most common extracranial solid neoplasms in children. Early and adequate tissue sampling may speed up the diagnostic process and ensure a prompt start of optimal treatment whenever needed. Different biopsy techniques have been described. The purpose of this multi-center study is to evaluate the accuracy and safety of the various examined techniques and to determine whether a preferential procedure exists.

Methods: All children who underwent a biopsy, from January 2010 to December 2014, as a result of being diagnosed with a peripheral neuroblastic tumor, were retrospectively reviewed. Data collected included patients' demographics, clinical presentation, intraoperative technical details, postoperative parameters, complications, and histology reports. The Mann-Whitney U and Fisher's exact tests were used for statistical analysis.

Results: The cohort included 100 patients, 32 of whom underwent an incisional biopsy (performed through open or minimally invasive access) (Group A), and the remaining 68 underwent multiple needle-core biopsies (either imaging-guided or laparoscopy/thoracoscopy-assisted) (Group B). Comparing the two groups revealed that Group A patients had a higher rate of complications, a greater need for postoperative analgesia, and required red blood cell transfusion more often. Overall adequacy rate was 94%, without significant differences between the two groups (100% vs. 91.2% for Group A and Group B, respectively, P = 0.0933).

Conclusions: Both incision and needle-core biopsying methods provided sub-optimal to optimal sampling adequacy rates in children affected by peripheral neuroblastic tumors. However, the former method was associated with a higher risk of both intraoperative and postoperative complications compared with the latter.

Keywords: biopsy; imaging-guided needle-core biopsy; minimally invasive surgery; neuroblastoma; pathology; pediatric.

Publication types

  • Multicenter Study

MeSH terms

  • Adolescent
  • Biopsy, Needle / adverse effects
  • Biopsy, Needle / methods*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Image-Guided Biopsy / adverse effects
  • Image-Guided Biopsy / methods*
  • Infant
  • Infant, Newborn
  • Intraoperative Complications / epidemiology
  • Italy / epidemiology
  • Laparoscopy / methods*
  • Male
  • Minimally Invasive Surgical Procedures / adverse effects
  • Minimally Invasive Surgical Procedures / methods*
  • Neuroectodermal Tumors, Primitive, Peripheral / diagnosis*
  • Postoperative Complications / epidemiology
  • Retrospective Studies
  • Thoracoscopy / methods*