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Needle track seeding following biopsy of liver lesions; a systematic review and meta-analysis
  1. Michael A Silva (mikesilva10{at}gmail.com)
  1. University Hospital Birmingham Foundation Trust, United Kingdom
    1. Bassem Hegab (bassam.hegab{at}uhb.nhs.uk)
    1. University Hospital Birmingham Foundation Trust, United Kingdom
      1. Christopher J Hyde (c.j.hyde{at}bham.ac.uk)
      1. Department of Public Health and Epidemiology, University of Birmingham, United Kingdom
        1. Boliang Guo (b.guo{at}bham.ac.uk)
        1. Department of Public Health and Epidemiology, University of Birmingham, United Kingdom
          1. John A C Buckels (john.buckels{at}uhb.nhs.uk)
          1. University Hospital Birmingham Foundation Trust, United Kingdom
            1. Darius F Mirza (darius.mirza{at}uhb.nhs.uk)
            1. University Hospital Birmingham Foundation Trust, United Kingdom

              Abstract

              Background: Needle biopsy of a suspicious liver lesion could guide management in the setting of equivocal imaging and serology, though not recommended generally due to fear of tumour dissemination outside the liver. The incidence of needle track seeding following biopsy of a suspicious liver lesion is however ill defined.

              Methods: A systematic review and meta-analysis of observational studies published before March 2007 was performed. Studies that reported on needle tract seeding following biopsy of suspicious liver lesions were identified. Lesions suspected to be hepatocelleular cancer (HCC) were considered. Data on the type of needle biopsy, diagnosis, incidence of needle track seeding duration to seeding, follow up and impact on outcome were tabulated.

              Results: Eight studies identified by systematic review on biopsy of HCC were included in a meta-analysis. The pooled estimate of patient with seeding per 100 patients with HCC was 0.027 (95% CI 0.018 to 0.040). There was no difference whether a fixed or random effects model was used. Q was 4.802 with 7 degrees of freedom, p=0.684, thus observed heterogeneity was compatible with variation by chance alone. The pooled estimate of patient with seeding per 100 patients per year was 0.009 (95% CI 0.006 to 0.013), p=0.686.

              Conclusions: In this systematic review we have shown that the incidence of needle tract tumour seeding following biopsy of a HCC is 2.7% overall, or 0.9% per year.

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