Predictors of poor outcome following liver biopsy for the investigation of new hepatic space occupying lesion/s

Rachel Gingold-Belfer, Nadav Shinhar, Gil N. Bachar, Nidal Issa, Doron Boltin, Eran Sharon, Tzippy Shohat, Boris Sapoznikov, Ariel Swartz, Noam Peleg, Tom Konikoff, Hemda Schmilovitz-Weiss*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Ultrasound-guided percutaneous liver biopsy (UPLB) is currently performed mainly to determine if new hepatic space occupying lesions (SOL) represent benign, primary malignant, or metastatic disease. This study sought to investigate the outcome of UPLB in this setting. Methods: In a retrospective study, patients with a new hepatic SOL who underwent UPLB during 1/2006-12/2016 were included and followed to 12/2018. Clinical data and pathology reports were reviewed. Mortality within 60 days and no change in patients' management following UPLB were defined as medically futile. Results: Included 140 patients, 50% male, mean age 68.8 ± 11.5 years; 112 patients died, all of malignant disease. 32 patients (23%) died within 60 days of UPLB. Median post-UPLB survival was 151 days. Survival was significantly shorter in patients with >1 hepatic lesion (n = 108) or an extrahepatic malignant lesion (n = 77) (p = 0.0082, p = 0.0301, respectively). On Cox Proportional Hazards analysis, significant predictors of mortality within 60 days of UPLB were: age as a continuous variable, (HR 1.070, 95% CI 1.011–1.131, p = 0.018), serum albumin <2.9 g/dL, (HR 4.822 95% CI 1.335–17.425, p = 0.016) and serum LDH >1500 U/L (HR 9.443, 95% CI 3.404–26.197, p < 0.0001). Conclusions: In patients with these features or with disseminated disease, liver biopsy should be carefully reconsidered.

Original languageEnglish
Pages (from-to)19-24
Number of pages6
JournalClinical Imaging
Volume99
DOIs
StatePublished - Jul 2023

Keywords

  • Hepatic space occupying lesion
  • Liver biopsy
  • Medical futility

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