Evaluation of the diagnostic biopsy approach for children with hepatoblastoma: A report from the children's oncology group AHEP 0731 liver tumor committee.
J Pediatr Surg
; 55(4): 655-659, 2020 Apr.
Article
en En
| MEDLINE
| ID: mdl-31126688
ABSTRACT
BACKGROUND:
The histopathological assessment of pediatric liver tumors at presentation is critical to establish a diagnosis, guide treatment, and collect appropriate research samples. The purpose of this study was to evaluate complications associated with different approaches to liver biopsy for newly diagnosed hepatoblastoma.METHODS:
Children with hepatoblastoma were enrolled on Children's Oncology Group study AHEP0731 (September 2009-March 2012). This analysis evaluated the study cohort of initially unresectable patients who therefore underwent a biopsy procedure at diagnosis. The primary endpoint was clinically significant postbiopsy hemorrhage, defined as requiring red blood cell transfusion.RESULTS:
We identified 121 children who underwent open (nâ¯=â¯76, 63%), laparoscopic (nâ¯=â¯17, 14%), or percutaneous (nâ¯=â¯28, 23%) liver biopsies. All biopsy procedures yielded adequate tissue for diagnosis. Postbiopsy hemorrhage requiring transfusion occurred after 26% (nâ¯=â¯31) of biopsies. Need for blood product transfusion most frequently occurred following open (nâ¯=â¯27/76, 36%) and laparoscopic (nâ¯=â¯4/17, 24%) biopsies, compared with percutaneous (nâ¯=â¯0/28, 0%) biopsies (pâ¯<â¯0.01).CONCLUSIONS:
Pretreatment biopsy of pediatric liver tumors via a percutaneous approach yielded the lowest frequency of clinically significant hemorrhage requiring transfusion, without evidence of sacrificing diagnostic accuracy. LEVEL OF EVIDENCE Level I.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Hepatoblastoma
/
Neoplasias Hepáticas
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
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Prognostic_studies
Límite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
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Infant
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Male
Idioma:
En
Revista:
J Pediatr Surg
Año:
2020
Tipo del documento:
Article