OncologyEvolving biopsy techniques for the diagnosis of neuroblastoma in children☆,☆☆
Section snippets
Patient selection and study design
In this IRB-approved retrospective study, the charts of all children who underwent core needle biopsy and surgical wedge biopsy of intermediate- and high-risk neuroblastoma at Texas Children's Hospital (TCH) from 2011 to 2015 were reviewed. The study included 16 patients who underwent core needle biopsy and 18 patients who underwent surgical biopsy. Data recorded for each patient included patient demographics, the anatomical location of the tumor biopsy specimen, the largest dimension of the
Patient and tumor characteristics
Differences in patient demographics and tumor characteristics among the different biopsy methods in the recent cohort can be seen in Table 1. There were no statistically significant differences between the two biopsy groups regarding mean age at biopsy (P = 0.40), race (P = 0.90), or gender (P = 0.18). Tumor location was not significantly different between the two groups (P = 0.13).
The difference in mean tumor size, represented by the largest measured dimension, was statistically significant
Discussion
There is a growing body of literature in support of percutaneous core needle biopsy as a safe and efficacious method of obtaining adequate tissue for diagnosis of neuroblastoma in children [2], [6], [13], [14]. Despite the lack of an agreed-upon standard method of obtaining tissue for intermediate- and high-risk neuroblastoma in the pediatric population, surgeons at our academic institution demonstrated a trend in favor of percutaneous core needle biopsy over surgical biopsy over the last two
Conclusions
Surgeon-performed percutaneous core needle biopsy is adequate for complete tissue diagnosis of neuroblastoma and can be safely performed. This can be considered as an alternative to surgical biopsy when both biopsy methods are clinically indicated. The results at our institution over the last two decades support the emerging use of percutaneous core needle biopsy and minimally invasive surgical techniques, as these methods of biopsy are increasingly able to guide management by providing an
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2022, Journal of Pediatric SurgeryCitation Excerpt :To mitigate this potential issue, the College of American Pathologists protocol suggests multiple core biopsies of NB (at least 2–4 biopsied from the same tumor). A recent retrospective review comparing older (2002–2010) and recent cohorts (2011–2015) reported that the older needle core biopsy cohort had an average of 7 cores with an adequacy of 71% for complete characterization while the recent cohort had an average of 25 cores with an adequacy of 94% [9]. The College of American Pathologists protocol also asserts that grading can be performed on samples from metastatic sites, provided that the specimen is large enough to be representative [14].
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2020, Journal of Pediatric SurgeryCitation Excerpt :If image-guided percutaneous core needle biopsy is chosen, a generous number of large caliber cores verified by real-time involvement of the pathologist to ensure adequate viable tissue for complete assessment of biologic markers is highly encouraged. Reports on image-guided core needle biopsies have shown excellent diagnostic yields with low complication rates in pediatric solid masses including hepatoblastoma and neuroblastoma [33–35]. However, success in obtaining adequate tissue for ancillary testing is variable, ranging from 64% to 98% [36–39].
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2019, Biochemical and Biophysical Research CommunicationsCitation Excerpt :Neuroblastoma (NB) is the most common extracranial neoplasm occurring in infants and very young children [1]. Despite the fact that it is a rare type of cancer, NB accounts for nearly 8%–10% of all pediatric cancers and 15% of cancer-related deaths in children [2]. Currently, the approaches for treating NB include surgical resection, chemotherapy, radiotherapy, as well as myeloablative therapy with autologous stem cell rescue (ASCR) to relieve symptoms and improve quality of life.
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2019, Journal of Pediatric SurgeryCitation Excerpt :The standard biopsy procedure has traditionally been open or minimally-invasive surgical wedge biopsy for the establishment of neuroblastoma diagnosis in children. Percutaneous image-guided core needle biopsy is now increasingly used to characterize neuroblastoma and other pediatric solid tumors given its safety, diagnostic adequacy, and efficiency [39]. The choice of open or percutaneous biopsy is based on the availability of an accessible anatomic window to access the tumor and surgeon preference.
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