title: Needle biopsy through the abdominal wall for the diagnosis of gastrointestinal stromal tumour - Does it increase the risk for tumour cell seeding and recurrence?
abstract: 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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  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.affiliation: Department of Oncology, Skane University Hospital and Lund University, Lund, Sweden. Electronic address: mikael.eriksson@med.lu.se.
authors.forename: Mikael
authors.initials: M
authors.lastname: Eriksson
authors.affiliation: Sarcoma Center Berlin-Brandenburg, HELIOS Clinic Berlin-Buch, Berlin, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Reichardt
authors.affiliation: Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway.
authors.forename: Kirsten
authors.initials: K
authors.lastname: Sundby Hall
authors.affiliation: Schwerpunktpraxis for Oncology, Hematology and Ambulant Tumour Therapy, Düsseldorf, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Schütte
authors.affiliation: Department of Gastroenterology/Endocrinology, University of Göttingen, Göttingen, Germany.
authors.forename: Silke
authors.initials: S
authors.lastname: Cameron
authors.affiliation: Division of Surgical Oncology and Thoracic Surgery, Mannheim University Medical Center, Mannheim, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Hohenberger
authors.affiliation: Sarcoma Center, West German Cancer Center, University of Duisburg-Essen, Essen, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Bauer
authors.affiliation: 4Pharma Ltd, Turku, Finland.
authors.forename: Mika
authors.initials: M
authors.lastname: Leinonen
authors.affiliation: Sarcoma Center Berlin-Brandenburg, HELIOS Clinic Berlin-Buch, Berlin, Germany.
authors.forename: Annette
authors.initials: A
authors.lastname: Reichardt
authors.affiliation: Regional Cancer Center, Lund, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Rejmyr Davis
authors.affiliation: Department of Cancer Epidemiology, Lund University, Lund, Sweden.
authors.forename: Thor
authors.initials: T
authors.lastname: Alvegård
authors.affiliation: Department of Oncology, University of Helsinki, and Comprehensive Cancer Center, Helsinki University Hospital, Helsinki, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Joensuu
mesh_terms: D034861:Abdominal Wall; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000401:mortality / Q000517:prevention & control*; D046152:Gastrointestinal Stromal Tumors / Q000401:mortality / Q000473:pathology*; D006801:Humans; D000068877:Imatinib Mesylate / Q000627:therapeutic use; D053208:Kaplan-Meier Estimate; D008279:Magnetic Resonance Imaging; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000209:etiology* / Q000401:mortality; D009366:Neoplasm Seeding; D047428:Protein Kinase Inhibitors / Q000627:therapeutic use; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000970:Antineoplastic Agents; D047428:Protein Kinase Inhibitors; D000068877:Imatinib Mesylate
keywords: Adjuvant; GIST; Gastrointestinal stromal tumour; Imatinib; Needle biopsy; Risk of recurrence