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Received Dec 4, 2017; Revised Mar 17, 2018; Accepted Apr 16, 2018
This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
1. Introduction
1.1. Background
Soft tissue sarcomas are exceedingly rare tumors with a mesenchymal origin [1]. They most commonly occur in the soft tissues of extremities and present in pediatric patients more often than adults [2]. Prompt, accurate diagnosis of soft tissue masses can be critical in initiating treatment of these tumors, which can carry significant morbidity and mortality. Conventional diagnosis of soft tissue masses through open incisional biopsy has been shown to give accurate diagnoses in 91% to 96% of cases [3–8]. However, this technique has demonstrated increased rates of complications [4, 6, 9, 10] over less invasive biopsy techniques such as percutaneous core needle biopsy (CNB) or fine-needle aspiration (FNA) [3, 7, 11–13]. For this reason, percutaneous CNB has become increasingly common for initial biopsy of soft tissue masses, exhibiting accuracy rates of 80% to 98% [7, 11, 13–22].
1.2. Rationale
It has been suggested by multiple authors that percutaneous soft tissue biopsies should be performed at sarcoma referral centers under the care of experienced musculoskeletal oncologists, citing decreased accuracy and potential alterations in the clinical course when biopsies are performed in the community [7, 13, 15, 23–25]. However, many of these studies failed to account for fellowship-trained musculoskeletal oncologists that practice in community centers. Currently, there is no consensus in the orthopedic literature on percutaneous CNB of soft tissue masses performed in community clinics by experienced musculoskeletal oncologists. The goal of our study is to retrospectively examine the diagnostic accuracy of office-based percutaneous core needle biopsy (CNB) when performed by a community orthopedic surgeon with fellowship training in musculoskeletal oncology. Secondarily, we aim to determine if correct treatment would have been guided if only the clinic-based biopsy were performed.
2. Methods
2.1. Study Design and Setting
This retrospective chart review was performed under Institutional Review Board (IRB) approval with waiver of informed consent. The initial list of patients was generated using ICD and CPT codes related to percutaneous needle biopsy. All data were collected from the electronic medical records (EMRs)...