title: Open versus needle biopsy in diagnosing neuroblastoma.
abstract: BACKGROUND
  Open surgical biopsy is traditionally advocated prior to initiating therapy in UKCCLG neuroblastoma protocols. We report a single centre experience comparing the utility of open biopsy vs image guided needle biopsy in aiding the definitive diagnosis and risk stratification of neuroblastoma - (Shimada classification, MYCN expression, cytogenetics - 1p 11q, 17 q).
  
  
  METHODS
  Medical records of all new cases of neuroblastoma presenting to a single UKCCLG centre during January 2002-July 2013 were examined.
  
  
  RESULTS
  Thirty nine patients underwent a biopsy of primary tumour for neuroblastoma during the study. Twenty one children had open biopsy and eighteen cases had a needle biopsy. Staging of neuroblastoma revealed - stage 4 (n=26), stage 3 (n=7), stage 2 (n=3) and stage 4S (n=3). Sites of primary tumour were adrenal gland (n=20), abdomen (n=12), thoracic (n=4), abdomino-thoracic (n=2) and abdomino pelvic regions (n=1). All patients (open vs needle) had adequate tissue retrieved for histological diagnosis of neuroblastoma. One needle and one open biopsy case did not have MYCN status determined despite adequate tissue sampling. Seventeen patients (7 open and 10 needle biopsies) had 1p and 17q status reported in MLPA testing (Multiplex Ligation-dependent Probe Amplification). No single patient required a repeat tumour biopsy. Morbidity in the series was minimal with only one child - open biopsy group, requiring emergent laparotomy to control bleeding from an abdominal primary tumour. No complications were recorded with needle biopsy.
  
  
  CONCLUSIONS
  Open and image guided needle biopsy appear to yield adequate tissue sampling for diagnosis, risk classification and staging of neuroblastoma. Further larger co-operative studies may usefully guide national and international protocols.
authors.affiliation: Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Dhanya
authors.initials: D
authors.lastname: Mullassery
authors.affiliation: Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Videha
authors.initials: V
authors.lastname: Sharma
authors.affiliation: Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Adeline
authors.initials: A
authors.lastname: Salim
authors.affiliation: Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK; Division of Child Health, University of Liverpool, UK.
authors.forename: Wajid B
authors.initials: WB
authors.lastname: Jawaid
authors.affiliation: Department of Medical Oncology, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Barry L
authors.initials: BL
authors.lastname: Pizer
authors.affiliation: Department of Radiology, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK.
authors.forename: Laurence J
authors.initials: LJ
authors.lastname: Abernethy
authors.affiliation: Department of Paediatric Surgery, Alder Hey Children's Hospital NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK; Division of Child Health, University of Liverpool, UK. Electronic address: paul.losty@liverpool.ac.uk.
authors.forename: Paul D
authors.initials: PD
authors.lastname: Losty
mesh_terms: D001706:Biopsy; D001707:Biopsy, Needle; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D009367:Neoplasm Staging; D009447:Neuroblastoma / Q000473:pathology*; D012189:Retrospective Studies; D018570:Risk Assessment
keywords: Biological studies; NMYC; Needle biopsy; Neuroblastoma; Open biopsy