Antony Ceraulo1, Antoine Ouziel2, Emilie Lavergne3, Lionel Perrier3, Anne-Valérie Decouvelaere4, Franck Chotel5, Philippe Thiesse6, Perrine Marec-Berard2. 1. Institut d'Hématologie et d'Oncologie Pédiatriques (IHOPe), 1, place du Pr. Joseph Renault, 69008, Lyon, France. antony.ceraulo@chu-lyon.fr. 2. Institut d'Hématologie et d'Oncologie Pédiatriques (IHOPe), 1, place du Pr. Joseph Renault, 69008, Lyon, France. 3. Clinical Research and Innovation Direction (DRCI), Cancer Center Léon Bérard, Lyon, France. 4. Department of Pathology, Cancer Center Léon Bérard, Lyon, France. 5. Department of Pediatric Orthopedic Surgery, Hospices Civils de Lyon - Hôpital Femme-Mère Enfant, Bron, France. 6. Department of Radiology, Cancer Center Léon Bérard, Lyon, France.
Abstract
BACKGROUND: Percutaneous biopsy is the reference diagnostic procedure for adult musculoskeletal tumors. Its place in pediatrics is controversial and open biopsy remains recommended. OBJECTIVE: To assess diagnostic performance and feasibility of percutaneous biopsy performed on children and young adults for suspected malignant bone tumors. MATERIALS AND METHODS: We conducted a 5-year retrospective study including patients ≤21 years who underwent a bone biopsy for a suspected malignant bone tumor. We assessed diagnostic yield (percentage of analyzable biopsies), accuracy (percentage of accurate diagnoses among all analyzable biopsies) and efficacy (percentage of accurate diagnoses among all biopsies), costs, anesthetic requirements and sample availability for biomedical research. Patients diagnosed with an open biopsy were used to compare diagnostic performances, anesthetic requirements and costs. RESULTS: We included 90 percutaneous and 27 open biopsies in 117 patients. For percutaneous biopsy, diagnostic yield was 95.5% (95% confidence interval [CI] 88.8-98.7%), accuracy was 96.2% (95% CI 86.8-99.5%) and efficacy was 89.3% (95% CI 78.1-96.0%). There was no statistical difference with open biopsy (Fisher exact test, P > 0.05). Mean costs were reduced with percutaneous biopsy: €1,937 (standard deviation [SD] €2,408) versus €6,362 (SD €5,033; Mann-Whitney, P < 0.0001). Thirty-two of the 48 (67%) patients included in clinical trials and diagnosed with percutaneous biopsy had suitable samples for ancillary analyses. CONCLUSION: Percutaneous biopsy is a valid alternative to open biopsy for diagnosing pediatric and young adult primary malignant bone tumors.
BACKGROUND: Percutaneous biopsy is the reference diagnostic procedure for adult musculoskeletal tumors. Its place in pediatrics is controversial and open biopsy remains recommended. OBJECTIVE: To assess diagnostic performance and feasibility of percutaneous biopsy performed on children and young adults for suspected malignant bone tumors. MATERIALS AND METHODS: We conducted a 5-year retrospective study including patients ≤21 years who underwent a bone biopsy for a suspected malignant bone tumor. We assessed diagnostic yield (percentage of analyzable biopsies), accuracy (percentage of accurate diagnoses among all analyzable biopsies) and efficacy (percentage of accurate diagnoses among all biopsies), costs, anesthetic requirements and sample availability for biomedical research. Patients diagnosed with an open biopsy were used to compare diagnostic performances, anesthetic requirements and costs. RESULTS: We included 90 percutaneous and 27 open biopsies in 117 patients. For percutaneous biopsy, diagnostic yield was 95.5% (95% confidence interval [CI] 88.8-98.7%), accuracy was 96.2% (95% CI 86.8-99.5%) and efficacy was 89.3% (95% CI 78.1-96.0%). There was no statistical difference with open biopsy (Fisher exact test, P > 0.05). Mean costs were reduced with percutaneous biopsy: €1,937 (standard deviation [SD] €2,408) versus €6,362 (SD €5,033; Mann-Whitney, P < 0.0001). Thirty-two of the 48 (67%) patients included in clinical trials and diagnosed with percutaneous biopsy had suitable samples for ancillary analyses. CONCLUSION: Percutaneous biopsy is a valid alternative to open biopsy for diagnosing pediatric and young adult primary malignant bone tumors.
Authors: Bryan Mitton; Leanne L Seeger; Mark A Eckardt; Kambiz Motamedi; Fritz C Eilber; Scott D Nelson; Jeffrey J Eckardt; Noah Federman Journal: J Pediatr Hematol Oncol Date: 2014-07 Impact factor: 1.289
Authors: I Ray-Coquard; D Ranchère-Vince; P Thiesse; H Ghesquières; P Biron; M-P Sunyach; M Rivoire; L Lancry; P Méeus; C Sebban; J-Y Blay Journal: Eur J Cancer Date: 2003-09 Impact factor: 9.162
Authors: Hyun-Joon Shin; Joao G Amaral; Derek Armstrong; Peter G Chait; Michael J Temple; Philip John; Charles R Smith; Glenn Taylor; Bairbre L Connolly Journal: Pediatr Radiol Date: 2007-02-14