A Comparison of Commonly Utilized Diagnostic Biopsy Techniques for Pediatric Patients With Cancer: A Systematic Review by the APSA Cancer Committee
Topic overview
This APSA systematic review of 2,477 pediatric cancer patients found core needle biopsy achieved 90.8% diagnostic accuracy with significantly lower complication rates (2.9%) compared to surgical biopsy (21.4%), though surgical biopsy remained more diagnostic (98.8%). The findings support CNB as a safe first-line approach for pediatric solid tumor diagnosis.
Key takeaways
- Core needle biopsy achieved 90.8% diagnostic success vs 98.8% for surgical biopsy in 2477 pediatric cancer patients across multiple tumor types.
- Complication rates were 10-fold lower with CNB (2.9%) compared to surgical biopsy (21.4%), primarily due to reduced bleeding risk (2.3% vs 22.1%).
- CNB offers acceptable diagnostic accuracy with significantly lower morbidity for pediatric solid tumors including neuroblastoma, liver tumors, and sarcomas.
- The 8% diagnostic gap between CNB and surgical biopsy may be acceptable given the substantial reduction in procedure-related complications.
- Future research should focus on optimizing CNB technique to improve diagnostic yield while preserving its safety advantage over open surgical approaches.
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