Evolving biopsy techniques for the diagnosis of neuroblastoma in children.

Abstract Background/Purpose To compare the adequacy and safety of percutaneous core needle biopsy and surgical wedge biopsy of neuroblastoma in children. Methods A retrospective review of patients who underwent biopsy for intermediate- or high-risk neuroblastoma at our institution between 2011 and 2015 was performed ( recent cohort ). Procedure details and outcomes were collected and analyzed using descriptive statistics and Wilcoxon rank tests; P historic cohort ). Results Since 2011, percutaneous, ultrasound-guided, core needle biopsy has been more commonly utilized (47% (16/34) recent vs. 25% (7/28) historic; P =  0.07), and the number of core needle samples increased from median 7 (historic) to 25 (recent). Complications decreased (21% (7/34) recent vs. 64% (18/28) historic; P P  = 1.00), which is improved from the historic cohort (71% percutaneous vs. 100% surgical; P  = 0.06). Larger tumors were more likely to have a percutaneous biopsy (82 ± 37 cm percutaneous vs. 47 ± 29 cm surgical; P  = 0.04). Conclusions When multiple cores are obtained, percutaneous core needle biopsy is adequate for complete tissue diagnosis of neuroblastoma and can be safely performed. This can be considered as an alternative to open surgical biopsy. Type of study Treatment Study. Level of evidence III.