Meta-analysisLiver cancer

Needle track seeding following biopsy of liver lesions in the diagnosis of hepatocellular cancer: a systematic review and meta-analysis

Gut · 20088 studies included in the meta-analysis (total number of patients not given in the abstract)

Silva MA, Hegab B, Hyde C, Guo B, Buckels JAC, Mirza DF. Gut. 2008. 57:1592-1596

Study type: Meta-analysis
Design: Systematic review and meta-analysis of observational studies (published before March 2007)
Sample size: 8 studies included in the meta-analysis (total number of patients not given in the abstract)
Source: Gut · 2008

In plain words

Sometimes, to diagnose liver cancer, a sample has to be taken from the liver lesion with a needle, but there is a concern that cancer cells could be planted along the needle's path. By pooling eight studies, this study showed that this happens in about 2.7% of patients (about 0.9% per year). The decision about having a biopsy should be made with the treating doctor and based on each patient's situation.

Key results

0.027 (95% CI 0.018–0.040)

Pooled estimate of patients with tumour seeding per 100 patients with HCC

Equivalent to 2.7% of patients (per the authors' conclusion); no difference between fixed-‎ and random-effects models

Q 4.802 with 7 degrees of freedom

Heterogeneity

P = 0.684; the observed heterogeneity was consistent with random variation alone

0.009 (95% CI 0.006–0.013)

Pooled estimate of patients with tumour seeding per 100 patients per year

Equivalent to 0.9% per year; P = 0.686

2.7% overall, or 0.9% per year

Incidence of needle track seeding after HCC biopsy (authors' conclusion)

Study population

Observational studies reporting needle track tumour seeding after biopsy of suspicious liver lesions. Lesions suspected to be hepatocellular carcinoma (HCC) were examined.

Endpoints

Data on type of needle biopsy, diagnosis, incidence of needle track seeding, time to seeding, follow-up and effect on outcome were tabulated. The main measure was the incidence of needle track tumour seeding.

Safety and side effects

The safety outcome studied was needle track tumour seeding after biopsy, with an estimated incidence of 2.7% overall (0.9% per year). The abstract reports no other information on adverse effects of biopsy.

Clinical significance and place in guidelines

This meta-analysis provides a numerical estimate of the risk of needle track seeding after HCC biopsy (2.7% overall, 0.9% per year), which can be used in weighing the risks and benefits of biopsy, particularly when imaging and serology are inconclusive. The abstract gives no information on changes to guidelines; the current status of clinical guideline recommendations should be checked separately.

Limitations

This study is based on observational studies published before March 2007, with only eight studies included in the meta-analysis. Other details, including the total number of patients and study quality, are not given in the abstract and should be checked in the full text.

Original article (DOI)PubMed

This summary was prepared by the editorial team from the published paper; the original paper is the final reference. Read the original abstract on PubMed.