Mikael Eriksson1, Peter Reichardt2, Kirsten Sundby Hall3, Jochen Schütte4, Silke Cameron5, Peter Hohenberger6, Sebastian Bauer7, Mika Leinonen8, Annette Reichardt2, Maria Rejmyr Davis9, Thor Alvegård10, Heikki Joensuu11. 1. Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden. Electronic address: mikael.eriksson@med.lu.se. 2. Sarcoma Center Berlin-Brandenburg, HELIOS Clinic Berlin-Buch, Berlin, Germany. 3. Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway. 4. Schwerpunktpraxis for Oncology, Hematology and Ambulant Tumour Therapy, Düsseldorf, Germany. 5. Department of Gastroenterology/Endocrinology, University of Göttingen, Göttingen, Germany. 6. Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, Mannheim, Germany. 7. Sarcoma Center, West German Cancer Center, University of Duisburg-Essen, Essen, Germany. 8. 4Pharma Ltd, Turku, Finland. 9. Regional Cancer Center, Lund, Sweden. 10. Department of Cancer Epidemiology, Lund University, Lund, Sweden. 11. Department of Oncology, University of Helsinki, and Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
Abstract
PURPOSE:Preoperative percutaneous transabdominal wall biopsy may be considered to diagnose gastrointestinal stromal tumour (GIST) and plan preoperative treatment with tyrosine kinase inhibitors when an endoscopic biopsy is not possible. Hypothetically, a transabdominal wall biopsy might lead to cell seeding and conversion of a local GIST to a disseminated one. We investigated the influence of preoperative needle biopsy on survival outcomes. METHODS: We collected the clinical data from hospital case records of the 397 patients who participated in the Scandinavian Sarcoma Group (SSG) XVIII/Arbeitsgemeinschaft Internistische Onkologie (AIO) randomised trial and who had atransabdominal fine needle and/or core needle biopsy carried out prior to study entry. The SSG XVIII/AIO trial compared 1 and 3 years of adjuvant imatinib in a patient population with a high risk of GIST recurrence after macroscopically radical surgery. The primary end-point was recurrence-free survival (RFS), and the secondary end-points included overall survival (OS). RESULTS: A total of 47 (12.0%) out of the 393 patients with data available underwent a percutaneous biopsy. No significant difference in RFS or OS was found between the patients who underwent or did not undergo a percutaneous biopsy either in the entire series or in subpopulation analyses, except for a statistically significant RFS advantage for patients who had a percutaneous biopsy and a tumour ≥10 cm in diameter. CONCLUSION: A preoperative diagnostic percutaneous biopsy of a suspected GIST may not increase the risk for GIST recurrence in a patient population who receive adjuvant imatinib after the biopsy.
RCT Entities:
PURPOSE: Preoperative percutaneous transabdominal wall biopsy may be considered to diagnose gastrointestinal stromal tumour (GIST) and plan preoperative treatment with tyrosine kinase inhibitors when an endoscopic biopsy is not possible. Hypothetically, a transabdominal wall biopsy might lead to cell seeding and conversion of a local GIST to a disseminated one. We investigated the influence of preoperative needle biopsy on survival outcomes. METHODS: We collected the clinical data from hospital case records of the 397 patients who participated in the Scandinavian Sarcoma Group (SSG) XVIII/Arbeitsgemeinschaft Internistische Onkologie (AIO) randomised trial and who had a transabdominal fine needle and/or core needle biopsy carried out prior to study entry. The SSG XVIII/AIO trial compared 1 and 3 years of adjuvant imatinib in a patient population with a high risk of GIST recurrence after macroscopically radical surgery. The primary end-point was recurrence-free survival (RFS), and the secondary end-points included overall survival (OS). RESULTS: A total of 47 (12.0%) out of the 393 patients with data available underwent a percutaneous biopsy. No significant difference in RFS or OS was found between the patients who underwent or did not undergo a percutaneous biopsy either in the entire series or in subpopulation analyses, except for a statistically significant RFS advantage for patients who had a percutaneous biopsy and a tumour ≥10 cm in diameter. CONCLUSION: A preoperative diagnostic percutaneous biopsy of a suspected GIST may not increase the risk for GIST recurrence in a patient population who receive adjuvant imatinib after the biopsy.
Authors: Juan Manuel Sanchez-Hidalgo; Manuel Duran-Martinez; Rafael Molero-Payan; Sebastian Rufian-Peña; Alvaro Arjona-Sanchez; Angela Casado-Adam; Antonio Cosano-Alvarez; Javier Briceño-Delgado Journal: World J Gastroenterol Date: 2018-05-14 Impact factor: 5.742