OBJECTIVES: To evaluate the use of image-guided biopsy (IGB) in routine clinical practice to obtain site-specific diagnoses in women presenting with peritoneal carcinomatosis (PC). STUDY DESIGN: Retrospective case study. SETTING: Tertiary referral centre. POPULATION: A total of 149 consecutive women with PC who underwent IGB. METHODS: Biopsy was performed in women considered unsuitable for primary surgery because of poor performance status or disease unlikely to be optimally debulked, with a prior history of malignancy or where there was clinicoradiological uncertainty about primary tumour site. Standard haematoxylin-eosin histological analysis was supplemented with immunohistochemistry. MAIN OUTCOME MEASURES: The rate of site-specific diagnosis. RESULTS: A total of 149 women underwent IGB using computed tomography or ultrasound over a 6-year period. The only complication was one rectus sheath haematoma. In 138 (93%) women, a site-specific cancer diagnosis was made on the IGB (including 111 müllerian tract, 8 gastrointestinal tract, 4 breast and 3 lymphoma); in ten women, a repeat biopsy was necessary, giving an overall failure rate of 7%. In a further six women, malignancy was confirmed but a site-specific diagnosis could not be made, and in four women, biopsy showed benign tissue. A site-specific diagnosis was obtained in 29 of the 32 women (94%) with previous malignancy, of which 18/32 (56%) showed a new primary cancer. CONCLUSIONS: IGB is a safe and accurate technique for providing site-specific diagnoses in women with PC in routine clinical practice, including those with a previous relevant malignancy. IGB can replace laparoscopic or open biopsy in defining primary therapeutic options. The data would suggest that the biopsy should be performed with ultrasound where feasible.
OBJECTIVES: To evaluate the use of image-guided biopsy (IGB) in routine clinical practice to obtain site-specific diagnoses in women presenting with peritoneal carcinomatosis (PC). STUDY DESIGN: Retrospective case study. SETTING: Tertiary referral centre. POPULATION: A total of 149 consecutive women with PC who underwent IGB. METHODS: Biopsy was performed in women considered unsuitable for primary surgery because of poor performance status or disease unlikely to be optimally debulked, with a prior history of malignancy or where there was clinicoradiological uncertainty about primary tumour site. Standard haematoxylin-eosin histological analysis was supplemented with immunohistochemistry. MAIN OUTCOME MEASURES: The rate of site-specific diagnosis. RESULTS: A total of 149 women underwent IGB using computed tomography or ultrasound over a 6-year period. The only complication was one rectus sheath haematoma. In 138 (93%) women, a site-specific cancer diagnosis was made on the IGB (including 111 müllerian tract, 8 gastrointestinal tract, 4 breast and 3 lymphoma); in ten women, a repeat biopsy was necessary, giving an overall failure rate of 7%. In a further six women, malignancy was confirmed but a site-specific diagnosis could not be made, and in four women, biopsy showed benign tissue. A site-specific diagnosis was obtained in 29 of the 32 women (94%) with previous malignancy, of which 18/32 (56%) showed a new primary cancer. CONCLUSIONS: IGB is a safe and accurate technique for providing site-specific diagnoses in women with PC in routine clinical practice, including those with a previous relevant malignancy. IGB can replace laparoscopic or open biopsy in defining primary therapeutic options. The data would suggest that the biopsy should be performed with ultrasound where feasible.
Authors: John A Spencer; Michael J Weston; Samir A Saidi; Nafisa Wilkinson; Geoffrey D Hall Journal: Nat Rev Clin Oncol Date: 2010-11 Impact factor: 66.675
Authors: Robert L Dood; Nicole D Fleming; Robert L Coleman; Shannon N Westin; Olivia D Lara; Christopher J LaFargue; Jinsong Liu; Anil K Sood Journal: Int J Gynecol Cancer Date: 2018-10 Impact factor: 3.437
Authors: Nyree Griffin; Lee A Grant; Susan J Freeman; Mercedes Jimenez-Linan; Laurence H Berman; Helena Earl; Ahmed Ashour Ahmed; Robin Crawford; James Brenton; Evis Sala Journal: Eur Radiol Date: 2008-08-15 Impact factor: 5.315