The question of whether one should perform a core needle biopsy for a suspected gastric or intra-abdominal GIST, or elect for surgery without preoperative diagnosis as a primary treatment, has long been debated. Mr Myles Smith of the Royal Marsden Hospital collaborated recently with Dr Willem Van Houdt of the Netherlands Cancer Institute in Amsterdam (NKI) to try to answer this question.
In their study ‘Oncological Outcome After Diagnostic Biopsies in Gastrointestinal Stromal Tumors’ published in the Annals of Surgery, they identified 228 patients with a median follow-up time of 53 months, who had a preoperative biopsy of their GIST between 1996 and 2014.
They found that only one patient developed a needle tract recurrence (1.4%), and multivariate analysis demonstrated that biopsy did not influence the rate recurrence or disease specific survival. Therefore, Mr Smith recommends considering a pre-operative biopsy where possible, for patients with suspected gastric or intra-abdominal GIST, as it appears to be safe, and we know that accurate preoperative diagnosis with molecular profiling may be of benefit in guiding treatment.