Optimization of percutaneous biopsy for diagnosis and pretreatment risk assessment of neuroblastoma.

Abstract:

BACKGROUND:Image-guided percutaneous core needle biopsy (PCNB) is increasingly utilized to diagnose solid tumors. The objective of this study is to determine whether PCNB is adequate for modern biologic characterization of neuroblastoma. PROCEDURE:A multi-institutional retrospective study was performed by the Pediatric Surgical Oncology Research Collaborative on children with neuroblastoma at 12 institutions over a 3-year period. Data collected included demographics, clinical details, biopsy technique, complications, and adequacy of biopsies for cytogenetic markers utilized by the Children's Oncology Group for risk stratification. RESULTS:A total of 243 children were identified with a diagnosis of neuroblastoma: 79 (32.5%) tumor excision at diagnosis, 94 (38.7%) open incisional biopsy (IB), and 70 (28.8%) PCNB. Compared to IB, there was no significant difference in ability to accurately obtain a primary diagnosis by PCNB (95.7% vs 98.9%, P = .314) or determine MYCN copy number (92.4% vs 97.8%, P = .111). The yield for loss of heterozygosity and tumor ploidy was lower with PCNB versus IB (56.1% vs 90.9%, P < .05; and 58.0% vs. 88.5%, P < .05). Complications did not differ between groups (2.9 % vs 3.3%, P = 1.000), though the PCNB group had fewer blood transfusions and lower opioid usage. Efficacy of PCNB was improved for loss of heterozygosity when a pediatric pathologist evaluated the fresh specimen for adequacy. CONCLUSIONS:PCNB is a less invasive alternative to open biopsy for primary diagnosis and MYCN oncogene status in patients with neuroblastoma. Our data suggest that PCNB could be optimized for complete genetic analysis by standardized protocols and real-time pathology assessment of specimen quality.

journal_name

Pediatr Blood Cancer

journal_title

Pediatric blood & cancer

authors

Overman RE,Kartal TT,Cunningham AJ,Fialkowski EA,Naik-Mathuria BJ,Vasudevan SA,Malek MM,Kalsi R,Le HD,Stafford LC,Lautz TB,Many BT,Jones RE,Bütter A,Davidson J,Williams A,Dasgupta R,Lewis J,Troutt M,Aldrink JH,Man

doi

10.1002/pbc.28153

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

e28153

issue

5

eissn

1545-5009

issn

1545-5017

journal_volume

67

pub_type

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