TY - JOUR
T1 - Predictors of poor outcome following liver biopsy for the investigation of new hepatic space occupying lesion/s
AU - Gingold-Belfer, Rachel
AU - Shinhar, Nadav
AU - Bachar, Gil N.
AU - Issa, Nidal
AU - Boltin, Doron
AU - Sharon, Eran
AU - Shohat, Tzippy
AU - Sapoznikov, Boris
AU - Swartz, Ariel
AU - Peleg, Noam
AU - Konikoff, Tom
AU - Schmilovitz-Weiss, Hemda
N1 - Publisher Copyright:
© 2023 Elsevier Inc.
PY - 2023/7
Y1 - 2023/7
N2 - 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.
AB - 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.
KW - Hepatic space occupying lesion
KW - Liver biopsy
KW - Medical futility
UR - http://www.scopus.com/inward/record.url?scp=85152115860&partnerID=8YFLogxK
U2 - 10.1016/j.clinimag.2023.04.001
DO - 10.1016/j.clinimag.2023.04.001
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C2 - 37043869
AN - SCOPUS:85152115860
SN - 0899-7071
VL - 99
SP - 19
EP - 24
JO - Clinical Imaging
JF - Clinical Imaging
ER -