Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Surgery
Published in: BMC Surgery 1/2022

Open Access 01-12-2022 | Metastasis | Research

Needle tract seeding and abdominal recurrence following pre-treatment biopsy of gastrointestinal stromal tumors (GIST): results of a systematic review

Authors: Jens Jakob, Rashad Salameh, David Wichmann, Nicos Charalambous, Anne-Christine Zygmunt, Inga Kreisel, Judith Heinz, Michael Ghadimi, Ulrich Ronellenfitsch

Published in: BMC Surgery | Issue 1/2022

Login to get access

Abstract

Background

Gastrointestinal stromal tumors (GIST) are rare abdominal tumors. Pretreatment biopsies may be used to diagnose a GIST and enable tailored treatment. Some experts are skeptical about biopsies because they fear tumor cell seeding. The objective of this study was to determine if pretreatment biopsy is associated with increased tumor recurrence.

Methods

We performed a systematic literature search and included studies assessing the oncological outcome of GIST patients who underwent a pre-treatment core needle biopsy or fine needle aspiration. We assessed methodological quality with the Newcastle-Ottawa-Scale for non-randomized studies. This review was registered in the PROSPERO database (CRD42021170290).

Results

Three non-randomized studies and eight case reports comprising 350 patients were eligible for inclusion. No prospective study designed to answer the review question was found. One case of needle tract seeding after percutaneous core needle biopsy of GIST was reported. None of the studies reported an increased rate of abdominal recurrence in patients with pretreatment biopsy.

Conclusions

The existing evidence does not indicate a relevant risk of needle tract seeding or abdominal recurrence after pre-treatment biopsy of GIST. Biopsy can safely be done to differentiate GIST from other tumors and to select the most appropriate treatment.
Appendix
Available only for authorised users
Literature
1.
Ressing M, Wardelmann E, Hohenberger P, Jakob J, Kasper B, Emrich K, et al. Strengthening health data on a rare and heterogeneous disease: sarcoma incidence and histological subtypes in Germany. BMC Public Health. 2018;18(1):235.PubMedPubMedCentralCrossRef
2.
Soreide K, Sandvik OM, Soreide JA, Giljaca V, Jureckova A, Bulusu VR. Global epidemiology of gastrointestinal stromal tumours (GIST): a systematic review of population-based cohort studies. Cancer Epidemiol. 2016;40:39–46.PubMedCrossRef
3.
Nakahara M, Isozaki K, Hirota S, Miyagawa J, Hase-Sawada N, Taniguchi M, et al. A novel gain-of-function mutation of c-kit gene in gastrointestinal stromal tumors. Gastroenterology. 1998;115(5):1090–5.PubMedCrossRef
4.
Huss S, Pasternack H, Ihle MA, Merkelbach-Bruse S, Heitkötter B, Hartmann W, et al. Clinicopathological and molecular features of a large cohort of gastrointestinal stromal tumors (GISTs) and review of the literature: BRAF mutations in KIT/PDGFRA wild-type GISTs are rare events. Hum Pathol. 2017;62:206–14.PubMedCrossRef
5.
Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, et al. Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med. 2002;347(7):472–80.PubMedCrossRef
6.
Joensuu H, Roberts PJ, Sarlomo-Rikala M, Andersson LC, Tervahartiala P, Tuveson D, et al. Effect of the tyrosine kinase inhibitor STI571 in a patient with a metastatic gastrointestinal stromal tumor. N Engl J Med. 2001;344(14):1052–6.PubMedCrossRef
7.
Rizzo A, Nannini M, Novelli M, Dalia Ricci A, Scioscio VD, Pantaleo MA. Dose reduction and discontinuation of standard-dose regorafenib associated with adverse drug events in cancer patients: a systematic review and meta-analysis. Ther Adv Med Oncol. 2020;12:1758835920936932.PubMedPubMedCentralCrossRef
8.
9.
Casali PG, Abecassis N, Aro HT, Bauer S, Biagini R, Bielack S, et al. Soft tissue and visceral sarcomas: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(Suppl 4):iv51–67.PubMedCrossRef
10.
Judson I, Bulusu R, Seddon B, Dangoor A, Wong N, Mudan S. UK clinical practice guidelines for the management of gastrointestinal stromal tumours (GIST). Clin Sarcoma Res. 2017;7:6.PubMedPubMedCentralCrossRef
11.
Cavnar MJ, Seier K, Gönen M, Curtin C, Balachandran VP, Tap WD, et al. Prognostic factors after neoadjuvant imatinib for newly diagnosed primary gastrointestinal stromal tumor. J Gastrointest Surg. 2020.
12.
13.
Kurokawa Y, Yang HK, Cho H, Ryu MH, Masuzawa T, Park SR, et al. Phase II study of neoadjuvant imatinib in large gastrointestinal stromal tumours of the stomach. Br J Cancer. 2017;117(1):25–32.PubMedPubMedCentralCrossRef
14.
Rutkowski P, Gronchi A, Hohenberger P, Bonvalot S, Schoffski P, Bauer S, et al. Neoadjuvant imatinib in locally advanced gastrointestinal stromal tumors (GIST): the EORTC STBSG experience. Ann Surg Oncol. 2013;20(9):2937–43.PubMedCrossRef
15.
Wang SY, Wu CE, Lai CC, Chen JS, Tsai CY, Cheng CT, et al. Prospective evaluation of neoadjuvant imatinib use in locally advanced gastrointestinal stromal tumors: emphasis on the optimal duration of neoadjuvant imatinib use, safety, and oncological outcome. Cancers (Basel). 2019;11(3).
16.
Indio V, Schipani A, Nannini M, Urbini M, Rizzo A, De Leo A, et al. Gene expression landscape of SDH-deficient gastrointestinal stromal tumors. J Clin Med. 2021;10(5).
17.
Fernandez JA, Gomez-Ruiz AJ, Olivares V, Ferri B, Frutos MD, Soria T, et al. Clinical and pathological features of “small” GIST (</=2 cm). What is their prognostic value?=2 cm). What is their prognostic value?. Eur J Surg Oncol. 2018;44(5):580–6.PubMedCrossRef
18.
Apte SS, Radonjic A, Wong B, Dingley B, Boulva K, Chatterjee A, et al. Preoperative imaging of gastric GISTs underestimates pathologic tumor size: a retrospective, single institution analysis. J Surg Oncol. 2021;124(1):49–58.PubMedCrossRef
19.
Menge F, Jakob J, Kasper B, Smakic A, Gaiser T, Hohenberger P. Clinical presentation of gastrointestinal stromal tumors. Visc Med. 2018;34(5):335–40.PubMedPubMedCentralCrossRef
20.
Kang HC, Menias CO, Gaballah AH, Shroff S, Taggart MW, Garg N, et al. Beyond the GIST: mesenchymal tumors of the stomach. Radiographics. 2013;33(6):1673–90.PubMedPubMedCentralCrossRef
21.
Lin YM, Chiu NC, Li AF, Liu CA, Chou YH, Chiou YY. Unusual gastric tumors and tumor-like lesions: radiological with pathological correlation and literature review. World J Gastroenterol. 2017;23(14):2493–504.PubMedPubMedCentralCrossRef
22.
Shinya T, Inai R, Tanaka T, Akagi N, Sato S, Yoshino T, et al. Small bowel neoplasms: enhancement patterns and differentiation using post-contrast multiphasic multidetector CT. Abdom Radiol (NY). 2017;42(3):794–801.CrossRef
23.
Casali PG, Abecassis N, Aro HT, Bauer S, Biagini R, Bielack S, et al. Gastrointestinal stromal tumours: ESMO-EURACAN Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2018;29(Suppl 4):iv68–78.PubMed
24.
Pavel M, Öberg K, Falconi M, Krenning EP, Sundin A, Perren A, et al. Gastroenteropancreatic neuroendocrine neoplasms: ESMO Clinical Practice Guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2020;31(7):844–60.PubMedCrossRef
25.
Romain B, Delhorme JB, Manceau G, Lefevre JH, Tresallet C, Mariani P, et al. Is nonanatomic rectal resection a valid therapeutic option for rectal gastrointestinal stromal tumors? A proposed decision algorithm. J Surg Oncol. 2020;122(8):1639–46.PubMedCrossRef
26.
Bergenfeldt M, Genell S, Lindholm K, Ekberg O, Aspelin P. Needle-tract seeding after percutaneous fine-needle biopsy of pancreatic carcinoma. Case report. Acta Chir Scand. 1988;154(1):77–9.PubMed
27.
Lee IS, Nguyen S, Shanberg AM. Needle tract seeding after percutaneous biopsy of Wilms tumor. J Urol. 1995;153(3 Pt 2):1074–6.PubMed
28.
Pasieka JL, Thompson NW. Fine-needle aspiration biopsy causing peritoneal seeding of a carcinoid tumor. Arch Surg. 1992;127(10):1248–51.PubMedCrossRef
29.
Takahashi N, Taniguchi T, Adachi M. A case of needle tract seeding of an intraductal papillary neoplasm of the bile duct (IPNB) after percutaneous biopsy. Eur J Dermatol. 2014;24(1):128–30.PubMedCrossRef
30.
Vergara V, Garripoli A, Marucci MM, Bonino F, Capussotti L. Colon cancer seeding after percutaneous fine needle aspiration of liver metastasis. J Hepatol. 1993;18(3):276–8.PubMedCrossRef
31.
32.
Akahoshi K, Sumida Y, Matsui N, Oya M, Akinaga R, Kubokawa M, et al. Preoperative diagnosis of gastrointestinal stromal tumor by endoscopic ultrasound-guided fine needle aspiration. World J Gastroenterol. 2007;13(14):2077–82.PubMedPubMedCentralCrossRef
33.
Ando N, Goto H, Niwa Y, Hirooka Y, Ohmiya N, Nagasaka T, et al. The diagnosis of GI stromal tumors with EUS-guided fine needle aspiration with immunohistochemical analysis. Gastrointest Endosc. 2002;55(1):37–43.PubMedCrossRef
34.
He Z, Sun C, Wang J, Zheng Z, Yu Q, Wang T, et al. Efficacy and safety of endoscopic submucosal dissection in treating gastric subepithelial tumors originating in the muscularis propria layer: a single-center study of 144 cases. Scand J Gastroenterol. 2013;48(12):1466–73.PubMedCrossRef
35.
Sato T, Peiper M, Fritscher-Ravens A, Gocht A, Soehendra N, Knoefel WT. Strategy of treatment of submucosal gastric tumors. Eur J Med Res. 2005;10(7):292–5.PubMed
36.
Vander Noot MR, Eloubeidi MA, Chen VK, Eltoum I, Jhala D, Jhala N, et al. Diagnosis of gastrointestinal tract lesions by endoscopic ultrasound-guided fine-needle aspiration biopsy. Cancer. 2004;102(3):157–63.PubMedCrossRef
37.
Yang Z, Feng X, Zhang P, Chen T, Qiu H, Zhou Z, et al. Clinicopathological features and prognosis of 276 cases of primary small (≤ 2 cm) gastric gastrointestinal stromal tumors: a multicenter data review. Surg Endosc. 2019;33(9):2982–90.PubMedCrossRef
38.
Terada T. Gastrointestinal stromal tumor of the digestive organs: a histopathologic study of 31 cases in a single Japanese institute. Int J Clin Exp Pathol. 2009;3(2):162–8.PubMedPubMedCentral
39.
Scarpa M, Bertin M, Ruffolo C, Polese L, D’Amico DF, Angriman I. A systematic review on the clinical diagnosis of gastrointestinal stromal tumors. J Surg Oncol. 2008;98(5):384–92.PubMedCrossRef
40.
Madden JF, Burchette JL, Raj GV, Daly JT, Tannenbaum M. Anterior rectal wall gastrointestinal stromal tumor presenting clinically as prostatic mass. Urol Oncol. 2005;23(4):268–72.PubMedCrossRef
41.
Kakkar A, Mathur SR, Jain D, Iyer VK, Nalwa A, Sharma MC. Utility of DOG1 immunomarker in fine needle aspirates of gastrointestinal stromal tumor. Acta Cytolog. 2015;59(1):61–7.CrossRef
42.
Dhaliwal A, Kolli S, Dhindsa BS, Devani K, Ramai D, Sayles H, et al. Clinical efficacy and safety of mucosal incision-assisted biopsy for the diagnosis of upper gastrointestinal subepithelial tumors: a systematic review and meta-analysis. Annal Gastroenterol. 2020;33(2):155–61.
43.
Blum MG, Bilimoria KY, Wayne JD, de Hoyos AL, Talamonti MS, Adley B. Surgical considerations for the management and resection of esophageal gastrointestinal stromal tumors. Annal Thorac Surg. 2007;84(5):1717–23.CrossRef
44.
Artigiani Neto R, Logullo AF, Stávale JN, Lourenço LG. Ki-67 expression score correlates to survival rate in gastrointestinal stromal tumors (GIST). Acta Cirurg Brasileira. 2012;27(5):315–21.CrossRef
45.
Hølmebakk T, Hompland I, Bjerkehagen B, Stoldt S, Bruland ØS, Hall KS, et al. Recurrence-free survival after resection of gastric gastrointestinal stromal tumors classified according to a strict definition of tumor rupture: a population-based study. Ann Surg Oncol. 2018;25(5):1133–9.PubMedCrossRef
46.
Čečka F, Jon B, Ferko A, Šubrt Z, Nikolov DH, Tyčová V. Long-term survival of a patient after resection of a gastrointestinal stromal tumor arising from the pancreas. Hepatobiliary Pancreat Dis Int. 2011;10(3):330–2.PubMedCrossRef
47.
Kane WJ, Friel CM. Diagnosis and treatment of rectal gastrointestinal stromal tumors. Dis Colon Rectum. 2019;62(5):537–40.PubMedCrossRef
48.
Nakamura T, Mitomi H, Onozato W, Sato T, Ikeda A, Naito M, et al. Laparoscopic resection of a gastrointestinal stromal tumor of the rectum after treatment with imatinib mesylate: report of a case. Surg Today. 2012;42(11):1096–9.PubMedCrossRef
49.
Suzuki T, Sadahiro S, Tanaka A, Okada K, Okamura H, Machida T, et al. Gastrointestinal stromal tumor of the rectum: report of three cases. Tokai J Exp Clin Med. 2011;36(3):58–62.PubMed
50.
Wang M, Qiu X, He X, Tian C. Characteristic of extra luminal gastric stromal tumor arising from the lesser curvature of the stomach: a case report. Medicine (Baltimore). 2020;99(16):e19885.CrossRef
51.
Wollina U, Hansel G, Zimmermann F, Schönlebe J, Nowak A. Merkel cell carcinoma of the lower leg with retroperitoneal GIST: a very rare association. Wien Klin Wochenschr. 2015;127(9–10):402–5.PubMedCrossRef
52.
Yin X, Shen C, Yin Y, Cai Z, Chen Z, Zhang B. Giant gastric stromal tumor mimicking as a posterior mediastinal mass: a case report and literature review. Medicine (Baltimore). 2018;97(41):e12816.CrossRef
53.
Zhang Q, Zhao JY, Zhuang H, Lu CY, Yao J, Luo Y, et al. Transperineal core-needle biopsy of a rectal subepithelial lesion guided by endorectal ultrasound after contrast-enhanced ultrasound: a case report. World journal of gastroenterology. 2021;27(13):1354–61.PubMedPubMedCentralCrossRef
54.
van Houdt WJ, NS IJ, Marjolein Schrijver A, Huis In ‘t Veld E, Thway K, Jones RL, et al. Oncological Outcome After Diagnostic Biopsies in Gastrointestinal Stromal Tumors: A Retrospective Cohort Study. Ann Surg. 2021;274(6):e1093-e8.
55.
Eriksson M, Reichardt P, Sundby Hall K, Schutte J, Cameron S, Hohenberger P, et al. Needle biopsy through the abdominal wall for the diagnosis of gastrointestinal stromal tumour—does it increase the risk for tumour cell seeding and recurrence? Eur J Cancer. 2016;59:128–33.PubMedCrossRef
56.
Akahoshi K, Oya M, Koga T, Koga H, Motomura Y, Kubokawa M, et al. Clinical usefulness of endoscopic ultrasound-guided fine needle aspiration for gastric subepithelial lesions smaller than 2 cm. J Gastrointestin Liver Dis. 2014;23(4):405–12.PubMedCrossRef
57.
Gronchi A, Bonvalot S, Poveda Velasco A, Kotasek D, Rutkowski P, Hohenberger P, et al. Quality of surgery and outcome in localized gastrointestinal stromal tumors treated within an international intergroup randomized clinical trial of adjuvant imatinib. JAMA Surg. 2020;155(6):e200397.PubMedPubMedCentralCrossRef
58.
Blay JY, Honore C, Stoeckle E, Meeus P, Jafari M, Gouin F, et al. Surgery in reference centers improves survival of sarcoma patients: a nationwide study. Ann Oncol. 2019;30(7):1143–53.PubMedPubMedCentralCrossRef
59.
Blay JY, Soibinet P, Penel N, Bompas E, Duffaud F, Stoeckle E, et al. Improved survival using specialized multidisciplinary board in sarcoma patients. Ann Oncol. 2017;28(11):2852–9.PubMedPubMedCentralCrossRef
60.
Silva MA, Hegab B, Hyde C, Guo B, Buckels JA, Mirza DF. Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis. Gut. 2008;57(11):1592–6.PubMedCrossRef
61.
Polyzos SA, Anastasilakis AD. A systematic review of cases reporting needle tract seeding following thyroid fine needle biopsy. World J Surg. 2010;34(4):844–51.PubMedCrossRef
62.
Volanis D, Neal DE, Warren AY, Gnanapragasam VJ. Incidence of needle-tract seeding following prostate biopsy for suspected cancer: a review of the literature. BJU Int. 2015;115(5):698–704.PubMedCrossRef
63.
Van Houdt WJ, Schrijver AM, Cohen-Hallaleh RB, Memos N, Fotiadis N, Smith MJ, et al. Needle tract seeding following core biopsies in retroperitoneal sarcoma. Eur J Surg Oncol. 2017;43(9):1740–5.PubMedCrossRef
64.
Renshaw AA, Powell A, Caso J, Gould EW. Needle track seeding in renal mass biopsies. Cancer Cytopathol. 2019;127(6):358–61.PubMedCrossRef
65.
Carrara S, Arcidiacono PG, Giussani A, Testoni PA. Acute hemorrhage with retroperitoneal hematoma after endoscopic ultrasound-guided fine-needle aspiration of an intraductal papillary mucinous neoplasm of the pancreas. Am J Gastroenterol. 2009;104(6):1610–1.PubMedCrossRef
66.
Lew SQ, Khan AA, Rieders B, Agrawal ST. Haemoperitoneum after an endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) of a pancreatic lesion in a peritoneal dialysis patient. BMJ Case Reports. 2020;13(11).
67.
Vassos N, Jakob J, Kähler G, Reichardt P, Marx A, Dimitrakopoulou-Strauss A, et al. Preservation of organ function in locally advanced non-metastatic gastrointestinal stromal tumors (GIST) of the stomach by neoadjuvant imatinib therapy. Cancers (Basel). 2021;13(4).
68.
Hohenberger P, Langer C, Wendtner CM, Hohenberger W, Pustowka A, Wardelmann E, et al. Neoadjuvant treatment of locally advanced GIST: Results of APOLLON, a prospective, open label phase II study in KIT- or PDGFRA-positive tumors. J Clin Oncol. 2012;30(15_suppl):10031.CrossRef
69.
Blesius A, Cassier PA, Bertucci F, Fayette J, Ray-Coquard I, Bui B, et al. Neoadjuvant imatinib in patients with locally advanced non metastatic GIST in the prospective BFR14 trial. BMC Cancer. 2011;11:72.PubMedPubMedCentralCrossRef
70.
Eisenberg BL, Harris J, Blanke CD, Demetri GD, Heinrich MC, Watson JC, et al. Phase II trial of neoadjuvant/adjuvant imatinib mesylate (IM) for advanced primary and metastatic/recurrent operable gastrointestinal stromal tumor (GIST): early results of RTOG 0132/ACRIN 6665. J Surg Oncol. 2009;99(1):42–7.PubMedPubMedCentralCrossRef
Metadata
Title
Needle tract seeding and abdominal recurrence following pre-treatment biopsy of gastrointestinal stromal tumors (GIST): results of a systematic review
Authors
Jens Jakob
Rashad Salameh
David Wichmann
Nicos Charalambous
Anne-Christine Zygmunt
Inga Kreisel
Judith Heinz
Michael Ghadimi
Ulrich Ronellenfitsch
Publication date
01-12-2022
Publisher
BioMed Central
Published in
BMC Surgery / Issue 1/2022
Electronic ISSN: 1471-2482
DOI
https://doi.org/10.1186/s12893-022-01648-2

Other articles of this Issue 1/2022

BMC Surgery 1/2022 Go to the issue

Research

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC) for ovarian cancer in an Australian institution: lessons from 20 years’ experience

Case report

Surgical treatment of recurrent intussusception induced by intestinal lymphoid hyperplasia in a child: is bowel resection always necessary? A case report

Research

Micromotion-based balanced drilling technology to increase near cortical strain

Research

Laparoscopic cholecystectomy during the COVID-19 pandemic in a tertiary care hospital in Germany: higher rates of acute and gangrenous cholecystitis in elderly patients

Case report

Primary duodenal papilla lymphoma producing obstructive jaundice: a case report

Research article

Available prediction scores of conversion for laparoscopic rectal cancer surgery seem to be unsuitable for nowadays rectal cancer management