title: Comparative retrospective study on the modalities of biopsying peripheral neuroblastic tumors: a report from the Italian Pediatric Surgical Oncology Group (GICOP).
abstract: Peripheral neuroblastic tumors are the most common extracranial solid neoplasms in children. Early and adequate tissue sampling may speed up the diagnostic process and ensure a prompt start of optimal treatment whenever needed. Different biopsy techniques have been described. The purpose of this multi-center study is to evaluate the accuracy and safety of the various examined techniques and to determine whether a preferential procedure exists.
  
  
  
  All children who underwent a biopsy, from January 2010 to December 2014, as a result of being diagnosed with a peripheral neuroblastic tumor, were retrospectively reviewed. Data collected included patients' demographics, clinical presentation, intraoperative technical details, postoperative parameters, complications, and histology reports. The Mann-Whitney U and Fisher's exact tests were used for statistical analysis.
  
  
  
  The cohort included 100 patients, 32 of whom underwent an incisional biopsy (performed through open or minimally invasive access) (Group A), and the remaining 68 underwent multiple needle-core biopsies (either imaging-guided or laparoscopy/thoracoscopy-assisted) (Group B). Comparing the two groups revealed that Group A patients had a higher rate of complications, a greater need for postoperative analgesia, and required red blood cell transfusion more often. Overall adequacy rate was 94%, without significant differences between the two groups (100% vs. 91.2% for Group A and Group B, respectively, P = 0.0933).
  
  
  
  Both incision and needle-core biopsying methods provided sub-optimal to optimal sampling adequacy rates in children affected by peripheral neuroblastic tumors. However, the former method was associated with a higher risk of both intraoperative and postoperative complications compared with the latter.
authors.affiliation: Department of Pediatric Surgery, IRCCS G. Gaslini, Genoa, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Avanzini
authors.affiliation: Department of Pediatric Surgery, IRCCS G. Gaslini, Genoa, Italy.|Department of Neuroscience, Rehabilitation, Ophtalmology, Gynecology, and Maternal-Infantile sciences (DINOGMI), University of Genoa, Genoa, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Faticato
authors.affiliation: Department of General and Thoracic Surgery, Bambino Gesù Children Hospital-Research Institute, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Crocoli
authors.affiliation: Department of Pediatric Surgery, Padova University Hospital, Padova, Italy.
authors.forename: Calogero
authors.initials: C
authors.lastname: Virgone
authors.affiliation: Department of Pediatric Surgery, Buzzi Hospital, Milan, Italy.
authors.forename: Camilla
authors.initials: C
authors.lastname: Viglio
authors.affiliation: Department of Pediatric Surgery, Meyer Children Hospital, Florence, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Severi
authors.affiliation: Department of Pediatric Surgery, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Fagnani
authors.affiliation: Department of Pediatric Surgery, Padova University Hospital, Padova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cecchetto
authors.affiliation: Department of Pediatric Surgery, Buzzi Hospital, Milan, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Riccipetitoni
authors.affiliation: Department of Pediatric Surgery, Meyer Children Hospital, Florence, Italy.
authors.forename: Bruno
authors.initials: B
authors.lastname: Noccioli
authors.affiliation: Department of Pediatric Surgery, Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.
authors.forename: Ernesto
authors.initials: E
authors.lastname: Leva
authors.affiliation: Department of Pathology, IRCCS G. Gaslini, Genoa, Italy.
authors.forename: Angela Rita
authors.initials: AR
authors.lastname: Sementa
authors.affiliation: Department of Pediatric Surgery, IRCCS G. Gaslini, Genoa, Italy.|Department of Neuroscience, Rehabilitation, Ophtalmology, Gynecology, and Maternal-Infantile sciences (DINOGMI), University of Genoa, Genoa, Italy.
authors.forename: Girolamo
authors.initials: G
authors.lastname: Mattioli
authors.affiliation: Department of General and Thoracic Surgery, Bambino Gesù Children Hospital-Research Institute, Rome, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Inserra
mesh_terms: D000293:Adolescent; D001707:Biopsy, Needle / Q000009:adverse effects / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D061705:Image-Guided Biopsy / Q000009:adverse effects / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D007431:Intraoperative Complications / Q000453:epidemiology; D007558:Italy / Q000453:epidemiology; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000175:diagnosis*; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D013906:Thoracoscopy / Q000379:methods*
keywords: biopsy; imaging-guided needle-core biopsy; minimally invasive surgery; neuroblastoma; pathology; pediatric