Assessment of cyclin D1 overexpression as a prognostic factor in soft tissue sarcomas: role of laparoscopy and core needle biopsy

Abstract Background The degree of contamination of healthy tissue with tumor cells during a biopsy in bone or soft tissue sarcomas is clearly dependant on the type of biopsy. Some studies have confirmed a clinically relevant contamination of the biopsy tract after incisional biopsies, as opposed to core-needle biopsies. The aim of our prospective study was to evaluate the risk of local recurrence depending on the biopsy type in extremity and pelvis sarcomas. Methods We included 162 patients with a minimum follow-up of 6 months after wide resection of extremity sarcomas. All diagnostic and therapeutic procedures were performed at a single, dedicated sarcoma center. The excision of the biopsy tract after an incisional biopsy was performed as a standard with all tumor resections. All patients received their follow-up after the conclusion of therapy at our center by means of regional MRI studies and, at a minimum, CT of the thorax to rule out pulmonary metastatic disease. The aim of the study was the evaluation of the influence of the biopsy type and of several other clinical factors on the rate of local recurrence and on the time of local recurrence-free survival. Results One hundred sixty-two patients with bone or soft tissue tumors of the extremities and the pelvis underwent either an incisional or a core-needle biopsy of their tumor, with 70 sarcomas (43.2%) being located in the bone. 84.6% of all biopsies were performed as core-needle biopsies. The median follow-up time was 55.6 months, and 22 patients (13.6%) developed a local recurrence after a median time of 22.4 months. There were no significant differences between incisional and core-needle biopsy regarding the risk of local recurrence in our subgroup analysis with differentiation by kind of tissue, grading of the sarcoma, and perioperative multimodal therapy. Conclusions In a large and homogenous cohort of extremity and pelvic sarcomas, we did not find significant differences between the groups of incisional and core-needle biopsy regarding the risk of local recurrence. The excision of the biopsy tract after incisional biopsy in the context of the definitive tumor resection seems to be the decisive factor for this result.

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Sampling Modality Influences the Predictive Value of Grading in Adult Soft Tissue Extremity Sarcomas

Archives of Pathology & Laboratory Medicine ◽

10.5858/arpa.2012-0427-oa ◽

2013 ◽

Vol 137 (12) ◽

pp. 1774-1779 ◽

Cited By ~ 11

Author(s):

Hatim Khoja ◽

Anthony Griffin ◽

Brendan Dickson ◽

Jay Wunder ◽

Peter Ferguson ◽

...

Keyword(s):

Soft Tissue ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Spindle Cell ◽

Soft Tissue Sarcomas ◽

Disease Free Survival ◽

Incisional Biopsy ◽

Free Survival ◽

Core Needle ◽

Disease Free

Context.—Histologic grade is one of the best predictors of outcome in adult soft tissue sarcomas. Current grading systems were validated on resection specimens; however, there has been a trend toward the use of biopsies to diagnosis these tumors. Objectives.—To determine whether the grade of an extremity soft tissue sarcoma determined on tissue obtained by either core needle biopsy or incisional biopsy is predictive of metastasis- or disease-free survival, and whether either sampling modality is superior. Design.—One hundred three core needle biopsies and 107 incisional biopsies of nonmetastatic spindle cell sarcomas of the extremities were retrieved from the archives. All cases had a minimum 2-year follow-up. Patient data and outcome and tumor characteristics were recorded. Tumors were reviewed and evaluated using the French Federation of Cancer Centers Sarcoma Group grading system. Kaplan-Meier survival curves were generated to correlate tumor grade with metastasis- and disease-free survival for both groups. Results.—Patient and tumor characteristics were similar between groups except that more tumors were grade 3 and superficial in the incisional biopsy group. Grade determined on core needle biopsy was not predictive of either metastasis-free survival (P = .59) or disease-free survival (P = .50). In contrast, grade determined on incisional biopsy was predictive of both metastasis-free survival (P < .001) and disease-free survival (P = .001). Conclusions.—Biopsy, particularly core needle biopsy, represents a convenient diagnostic tool, particularly in the context of neoadjuvant therapy. However, based on these results incisional biopsy is recommended if grading is to be used to predict prognosis in spindle cell soft tissue sarcomas of the extremities.

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Relative Sensitivity of Core-Needle Biopsy and Incisional Biopsy in the Diagnosis of Musculoskeletal Sarcomas

Cancers ◽

10.3390/cancers13061393 ◽

2021 ◽

Vol 13 (6) ◽

pp. 1393

Author(s):

Alexander Klein ◽

Theresa Fell ◽

Christof Birkenmaier ◽

Julian Fromm ◽

Volkmar Jansson ◽

...

Keyword(s):

Soft Tissue ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Histopathological Examination ◽

Statistical Significance ◽

Soft Tissue Sarcomas ◽

Incisional Biopsy ◽

Tissue Samples ◽

Core Needle ◽

Significant Difference

Background: There is no evidence as to the diagnostic value of the two most frequently used methods of biopsies in sarcomas: Incisional or core needle biopsy. The aim of our study was to evaluate the diagnostic sensitivity of the incisional and the core needle biopsy techniques in the diagnosis of bone and soft tissue sarcomas. Methods: We included 417 patients with a definitive diagnosis of bone or soft tissue sarcoma in whom a total of 472 biopsies had been performed. We correlated the results of the biopsies with the result of the definitive histopathological examination of the resected tumor. Dignity, entity, and grading (whenever possible) of the tissue samples were evaluated. Results: A total of 258 biopsies (55%) were performed in order to diagnose a soft tissue tumor and 351 biopsies (74.4%) were core needle biopsies. The number of repeat core needle biopsies, necessitated because of inconclusive histopathological results, was significantly higher (50 vs. 5; p = 0.003). We observed no significant difference regarding dignity, entity, and grading between the 2 different types of biopsies. Only with regards to the determination of dignity and entity of chondroid tumors, incisional biopsy was superior with statistical significance (p = 0.024). Conclusions: This study represents the largest study on biopsies for bone and soft tissue sarcomas. Based only on our results, we are unable to favor one method of biopsy and found high accuracy with both methods. Considering the potential complications, the added oncological risks of incisional biopsies and the ready availability of core needle biopsies, the latter, in our assessment, represents a valid and favourable method for bone and soft tissue sarcomas.

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The role of core needle biopsy in the diagnosis of suspected soft tissue tumours

Journal of Surgical Oncology ◽

10.1002/jso.21600 ◽

2010 ◽

Vol 102 (5) ◽

pp. 523-529 ◽

Cited By ~ 79

Author(s):

D.C. Strauss ◽

Y.A. Qureshi ◽

A.J. Hayes ◽

K. Thway ◽

C. Fisher ◽

...

Keyword(s):

Soft Tissue ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Soft Tissue Tumours ◽

Core Needle

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Core needle biopsy versus incisional biopsy for differentiation of soft‐tissue sarcomas: A systematic review and meta‐analysis

Cancer ◽

10.1002/cncr.32735 ◽

2020 ◽

Vol 126 (9) ◽

pp. 1917-1928 ◽

Cited By ~ 5

Author(s):

Emrullah Birgin ◽

Cui Yang ◽

Svetlana Hetjens ◽

Christoph Reissfelder ◽

Peter Hohenberger ◽

...

Keyword(s):

Systematic Review ◽

Soft Tissue ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Meta Analysis ◽

Soft Tissue Sarcomas ◽

Incisional Biopsy ◽

Core Needle

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Percutaneous Imaging-Guided versus Open Musculoskeletal Biopsy: Concepts and Controversies

Seminars in Musculoskeletal Radiology ◽

10.1055/s-0040-1717113 ◽

2020 ◽

Vol 24 (06) ◽

pp. 667-675

Author(s):

Violeta Vasilevska Nikodinovska ◽

Slavcho Ivanoski ◽

Milan Samardziski ◽

Vesna Janevska

Keyword(s):

Soft Tissue ◽

Complication Rate ◽

Core Needle Biopsy ◽

Multidisciplinary Team ◽

Gold Standard ◽

Needle Biopsy ◽

Soft Tissue Tumors ◽

Open Biopsy ◽

Core Needle ◽

Similar Accuracy

AbstractBone and soft tissue tumors are a largely heterogeneous group of tumors. Biopsy of musculoskeletal (MSK) tumors is sometimes a challenging procedure. Although the open biopsy is still considered the gold standard for the biopsy of MSK lesions, core needle biopsy can replace it in most cases, with similar accuracy and a low complication rate. The biopsy should be performed in a tertiary sarcoma center where the multidisciplinary team consists of at minimum a tumor surgeon, an MSK pathologist, and an MSK radiologist who can assess all steps of the procedure. Several factors can influence the success of the biopsy including the lesion characteristics, the equipment, and the method used for the procedure. This review highlights some of the important aspects regarding the biopsy of the MSK tumors, with special attention to imaging a guided core needle biopsy and highlighting some of the recent advancements and controversies in the field.

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Evaluation of a Soft Tissue Mass in the Extremity or Trunk

10.2310/cgso.16095 ◽

2018 ◽

Author(s):

Daniel C Thomas ◽

Dale Han

Keyword(s):

Soft Tissue ◽

Soft Tissue Sarcoma ◽

Physical Examination ◽

Core Needle Biopsy ◽

Needle Biopsy ◽

Malignant Tumors ◽

Soft Tissue Mass ◽

Tissue Mass ◽

Core Needle ◽

Needle Tract

Soft tissue sarcoma (STS) represents a diverse group of malignant tumors derived from mesenchymal elements. Evaluation of a soft tissue mass of the trunk or extremity starts with a detailed history and physical examination, which will help guide further diagnostic evaluation. Imaging should then be obtained for an STS, with MRI being the preferred modality for the trunk or extremities. Imaging can assist with diagnosis and delineate the extent of the primary lesion, including the relationship to contiguous structures, for treatment planning and assessing resectability. Pathology diagnosis is most commonly performed via examination of a specimen obtained through image-guided percutaneous core-needle biopsy. This requires multidisciplinary planning between Surgery and Radiology to place the needle within the anticipated definitive surgical incision to allow for en bloc resection of the needle tract. Once the diagnosis of an STS is made, appropriate staging studies should be performed based on the history and physical examination and tumor histology, grade, and size. Clinical and pathology data are used to stage STS patients using the American Joint Committee on Cancer staging system, which incorporates the STS site, size and grade of the primary tumor, and absence or presence of nodal and distant metastatic disease. This review contains 6 figures, 6 tables and 50 references Key words: core-needle biopsy, extremity, histology, imaging, risk factors, soft tissue mass, soft tissue sarcoma, staging evaluation, trunk, tumor grade

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