Clinical

Needle biopsy may lead to liver tumor dissemination

Last Updated: 2008-11-11 17:06:22 -0400 (Reuters Health)

NEW YORK (Reuters Health) - The incidence of needle track seeding following biopsy of suspected hepatocellular cancer (HCC) appears to be 2.7%, according to findings of a meta-analysis by UK researchers published in the November issue of Gut.

Dr. Darius F. Mirza of University Hospital Birmingham NHS Trust and colleagues note that needle biopsy in such circumstances might be informative, but is not generally recommended because of the risk of seeding. However, the incidence is ill defined.

To investigate further, the researchers reviewed the literature and identified seven retrospective and one prospective observational study that reported on needle track seeding in a total of 1340 patients.

The team calculated that the incidence of HCC overall was 2.7%, or 0.9% per year. There is some uncertainty, they add, but the highest rates with which the data from the studies are compatible would be 4.0% overall or 1.3% per year.

In none of these reported cases of seeding was patient survival affected, and the lesion was successfully treated by resection and local ablation.

"Percutaneous image-guided biopsies of liver lesions should not be performed indiscriminately." Dr. Mirza told Reuters Health. "Nevertheless, there is a place for such a guided biopsy, but its use should be restricted to specialized liver transplant centers on a case-by-case basis, following multi-disciplinary review."

Gut 2008;57:1592-1596.