Safety and diagnostic accuracy of tumor biopsies in children with cancer

Rodrigo B. Interiano, Amos H.P. Loh, Nathan Hinkle, Fazal N. Wahid, Alpin D. Malkan, Armita Bahrami, Jesse J. Jenkins, Shenghua Mao, Jianrong Wu, Kimberly Proctor, Victor M. Santana, Alberto S. Pappo, Robert Gold, Andrew M. Davidoff

Research output: Contribution to journalArticle

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Abstract

BACKGROUND Tumor biopsies are central to the diagnosis and management of cancer and are critical to efforts in personalized medicine and targeted therapeutics. In the current study, the authors sought to evaluate the safety and accuracy of biopsies in children with cancer. METHODS All biopsies performed in children at the study institution with a suspected or established diagnosis of cancer from 2003 through 2012 were reviewed retrospectively. Patient characteristics and disease-related and procedure-related factors were correlated with procedure-related complications and diagnostic accuracy using logistic regression analysis. RESULTS A total of 1073 biopsies were performed in 808 patients. Of 1025 biopsies with adequate follow-up, 79 (7.7%) were associated with an adverse event, 35 (3.4%) of which were minor (grade 1-2) and 32 (3.1%) of which were major (grade 3-4) (grading was performed according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.0]). The most common major adverse events were blood transfusion (>10 mL/kg; 24 cases) and infection requiring intravenous antibiotics (6 cases). Eleven deaths (1.4%) occurred within 30 days after the procedure, but the procedure may have contributed to the outcome in only 2 cases. A total of 926 biopsies (90.3%) provided definitive histologic diagnoses. Using multivariable analysis, biopsy site, preprocedure hematocrit level, and body mass index were found to be associated with the risk of postprocedural complications (P<.0001, P<.0001, and P =.0029, respectively). Excisional biopsy and biopsy site were found to be independently associated with obtaining a diagnostic result (P =.0002 and P =.0008, respectively). CONCLUSIONS Tumor biopsies in children with cancer are associated with a low incidence of complications and a high rate of diagnostic accuracy. The predictive factors identified for adverse outcomes may aid in risk assessment and preprocedural counseling. Cancer 2015;121:1098-1107.

Original languageEnglish (US)
Pages (from-to)1098-1107
Number of pages10
JournalCancer
Volume121
Issue number7
DOIs
StatePublished - Apr 1 2015

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Biopsy
Safety
Neoplasms
Precision Medicine
National Cancer Institute (U.S.)
Hematocrit
Terminology
Blood Transfusion
Counseling
Body Mass Index
Logistic Models
Regression Analysis
Anti-Bacterial Agents
Incidence
Infection

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Interiano, R. B., Loh, A. H. P., Hinkle, N., Wahid, F. N., Malkan, A. D., Bahrami, A., ... Davidoff, A. M. (2015). Safety and diagnostic accuracy of tumor biopsies in children with cancer. Cancer, 121(7), 1098-1107. https://doi.org/10.1002/cncr.29167

Safety and diagnostic accuracy of tumor biopsies in children with cancer. / Interiano, Rodrigo B.; Loh, Amos H.P.; Hinkle, Nathan; Wahid, Fazal N.; Malkan, Alpin D.; Bahrami, Armita; Jenkins, Jesse J.; Mao, Shenghua; Wu, Jianrong; Proctor, Kimberly; Santana, Victor M.; Pappo, Alberto S.; Gold, Robert; Davidoff, Andrew M.

In: Cancer, Vol. 121, No. 7, 01.04.2015, p. 1098-1107.

Research output: Contribution to journalArticle

Interiano, RB, Loh, AHP, Hinkle, N, Wahid, FN, Malkan, AD, Bahrami, A, Jenkins, JJ, Mao, S, Wu, J, Proctor, K, Santana, VM, Pappo, AS, Gold, R & Davidoff, AM 2015, 'Safety and diagnostic accuracy of tumor biopsies in children with cancer', Cancer, vol. 121, no. 7, pp. 1098-1107. https://doi.org/10.1002/cncr.29167
Interiano RB, Loh AHP, Hinkle N, Wahid FN, Malkan AD, Bahrami A et al. Safety and diagnostic accuracy of tumor biopsies in children with cancer. Cancer. 2015 Apr 1;121(7):1098-1107. https://doi.org/10.1002/cncr.29167
Interiano, Rodrigo B. ; Loh, Amos H.P. ; Hinkle, Nathan ; Wahid, Fazal N. ; Malkan, Alpin D. ; Bahrami, Armita ; Jenkins, Jesse J. ; Mao, Shenghua ; Wu, Jianrong ; Proctor, Kimberly ; Santana, Victor M. ; Pappo, Alberto S. ; Gold, Robert ; Davidoff, Andrew M. / Safety and diagnostic accuracy of tumor biopsies in children with cancer. In: Cancer. 2015 ; Vol. 121, No. 7. pp. 1098-1107.
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abstract = "BACKGROUND Tumor biopsies are central to the diagnosis and management of cancer and are critical to efforts in personalized medicine and targeted therapeutics. In the current study, the authors sought to evaluate the safety and accuracy of biopsies in children with cancer. METHODS All biopsies performed in children at the study institution with a suspected or established diagnosis of cancer from 2003 through 2012 were reviewed retrospectively. Patient characteristics and disease-related and procedure-related factors were correlated with procedure-related complications and diagnostic accuracy using logistic regression analysis. RESULTS A total of 1073 biopsies were performed in 808 patients. Of 1025 biopsies with adequate follow-up, 79 (7.7{\%}) were associated with an adverse event, 35 (3.4{\%}) of which were minor (grade 1-2) and 32 (3.1{\%}) of which were major (grade 3-4) (grading was performed according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.0]). The most common major adverse events were blood transfusion (>10 mL/kg; 24 cases) and infection requiring intravenous antibiotics (6 cases). Eleven deaths (1.4{\%}) occurred within 30 days after the procedure, but the procedure may have contributed to the outcome in only 2 cases. A total of 926 biopsies (90.3{\%}) provided definitive histologic diagnoses. Using multivariable analysis, biopsy site, preprocedure hematocrit level, and body mass index were found to be associated with the risk of postprocedural complications (P<.0001, P<.0001, and P =.0029, respectively). Excisional biopsy and biopsy site were found to be independently associated with obtaining a diagnostic result (P =.0002 and P =.0008, respectively). CONCLUSIONS Tumor biopsies in children with cancer are associated with a low incidence of complications and a high rate of diagnostic accuracy. The predictive factors identified for adverse outcomes may aid in risk assessment and preprocedural counseling. Cancer 2015;121:1098-1107.",
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AU - Loh, Amos H.P.

AU - Hinkle, Nathan

AU - Wahid, Fazal N.

AU - Malkan, Alpin D.

AU - Bahrami, Armita

AU - Jenkins, Jesse J.

AU - Mao, Shenghua

AU - Wu, Jianrong

AU - Proctor, Kimberly

AU - Santana, Victor M.

AU - Pappo, Alberto S.

AU - Gold, Robert

AU - Davidoff, Andrew M.

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N2 - BACKGROUND Tumor biopsies are central to the diagnosis and management of cancer and are critical to efforts in personalized medicine and targeted therapeutics. In the current study, the authors sought to evaluate the safety and accuracy of biopsies in children with cancer. METHODS All biopsies performed in children at the study institution with a suspected or established diagnosis of cancer from 2003 through 2012 were reviewed retrospectively. Patient characteristics and disease-related and procedure-related factors were correlated with procedure-related complications and diagnostic accuracy using logistic regression analysis. RESULTS A total of 1073 biopsies were performed in 808 patients. Of 1025 biopsies with adequate follow-up, 79 (7.7%) were associated with an adverse event, 35 (3.4%) of which were minor (grade 1-2) and 32 (3.1%) of which were major (grade 3-4) (grading was performed according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.0]). The most common major adverse events were blood transfusion (>10 mL/kg; 24 cases) and infection requiring intravenous antibiotics (6 cases). Eleven deaths (1.4%) occurred within 30 days after the procedure, but the procedure may have contributed to the outcome in only 2 cases. A total of 926 biopsies (90.3%) provided definitive histologic diagnoses. Using multivariable analysis, biopsy site, preprocedure hematocrit level, and body mass index were found to be associated with the risk of postprocedural complications (P<.0001, P<.0001, and P =.0029, respectively). Excisional biopsy and biopsy site were found to be independently associated with obtaining a diagnostic result (P =.0002 and P =.0008, respectively). CONCLUSIONS Tumor biopsies in children with cancer are associated with a low incidence of complications and a high rate of diagnostic accuracy. The predictive factors identified for adverse outcomes may aid in risk assessment and preprocedural counseling. Cancer 2015;121:1098-1107.

AB - BACKGROUND Tumor biopsies are central to the diagnosis and management of cancer and are critical to efforts in personalized medicine and targeted therapeutics. In the current study, the authors sought to evaluate the safety and accuracy of biopsies in children with cancer. METHODS All biopsies performed in children at the study institution with a suspected or established diagnosis of cancer from 2003 through 2012 were reviewed retrospectively. Patient characteristics and disease-related and procedure-related factors were correlated with procedure-related complications and diagnostic accuracy using logistic regression analysis. RESULTS A total of 1073 biopsies were performed in 808 patients. Of 1025 biopsies with adequate follow-up, 79 (7.7%) were associated with an adverse event, 35 (3.4%) of which were minor (grade 1-2) and 32 (3.1%) of which were major (grade 3-4) (grading was performed according to the National Cancer Institute Common Terminology Criteria for Adverse Events [version 4.0]). The most common major adverse events were blood transfusion (>10 mL/kg; 24 cases) and infection requiring intravenous antibiotics (6 cases). Eleven deaths (1.4%) occurred within 30 days after the procedure, but the procedure may have contributed to the outcome in only 2 cases. A total of 926 biopsies (90.3%) provided definitive histologic diagnoses. Using multivariable analysis, biopsy site, preprocedure hematocrit level, and body mass index were found to be associated with the risk of postprocedural complications (P<.0001, P<.0001, and P =.0029, respectively). Excisional biopsy and biopsy site were found to be independently associated with obtaining a diagnostic result (P =.0002 and P =.0008, respectively). CONCLUSIONS Tumor biopsies in children with cancer are associated with a low incidence of complications and a high rate of diagnostic accuracy. The predictive factors identified for adverse outcomes may aid in risk assessment and preprocedural counseling. Cancer 2015;121:1098-1107.

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