CORR Insights^®: Are Biopsy Tracts a Concern for Seeding and Local Recurrence in Sarcomas?

Excerpt

For patients with a bone or soft-tissue sarcoma, the critical step in directing treatment and determining prognosis is a tissue biopsy. Biopsies are commonly done by core needle biopsy with radiological assistance (ultrasound or CT scan), or by open surgical biopsy. Both methods generally provide sufficient material to determine a diagnosis, although open biopsy is more likely to do so at the cost of greater morbidity [1, 12]. Once a diagnosis is obtained and the definitive surgical resection is planned, the surgeon must decide whether or not to resect the biopsy tract along with the tumor. Due to the larger exposure and higher volume of exposed tumor tissue in surgical biopsies compared to needle biopsies, the risk for biopsy tract seeding with tumor cells is higher for open biopsies than for core needle biopsies. Fortunately, open-biopsy tracts are generally easy to see and resect; for this reason, and because of the increased risk of seeding associated with them, surgeons accept that open biopsy tracts should be excised at the time of the definitive tumor resection. …