Do we always need to resect the Percutaneous Biopsy Tract to perform a Limb Salvage Surgery for Sarcomas? - Abstract
Background and objectives: Resection of the biopsy track is a standardized procedure in musculoskeletal oncology, but there is no specific literature regarding the incidence of local recurrence and prognosis after resection or not of the biopsy tract when performing percutaneous biopsy. The aim of our study is to detect which factors determine the development of local recurrences, especially those related to the biopsy tract resection. Methods: We conducted an observational study with a retrospective analysis from prospectively collected data. The study included 121 patients (123 sarcomas from which 49 were bone sarcomas and 74 were soft tissue sarcomas) diagnosed after percutaneous biopsy and treated in our center from 2006 to 2012. We analyzed different factors that could influence on relapses such as biopsy track resection, histology and grade, margins and adjuvant treatments. We performed a multivariate analysis to detect the independent factors that affect the local recurrence rate. The minimum follow-up was two years. Results: In our series, local relapses are affected exclusively by margin status (p=0.003) and histological diagnosis (p=0.012). These factors are independent from other variables such as adjuvant therapy or resection or not of the biopsy tract (p=0.999). Conclusions: Obtaining adequate margins is the most single important factor for local recurrence or local recurrence free survival. We could not demonstrate statistically significant differences in patients in whom the resection of the biopsy tract was not performed.