PB2298 CORE BIOPSY (TRUCUT) GUIDED BY ECOGRAPHY FOR THE DIAGNOSIS OF ONCOHEMATOLOGICAL PATHOLOGY: A QUICK, SAFE AND EFFECTIVE ALTERNATIVE
Authors: Martínez R. Martos , Gutierrez F. Guerra , Platero M. Yuste , Arias E. Gonzalez , Martinez l. Bermejo , Alvarez P. Beltran , Martinez A. P.A.S.C.UAL , Sillero P. Llamas 
Published: June 2019

Background:

Hematological diagnoses with excisional biopsy in patients with adenopathies with suspected malignancy, generally entail a waiting period until the histological diagnosis that may interfere with the final prognosis of the patients. Shortening these waiting times, using specific techniques, can be a valid and safe alternative in selected patients. Ultrasound‐guided core biopsy techniques (trucut) could shorten these times, favoring the early initiation of treatments, and avoiding the adverse effects and consumption of health resources that imply a classic excision biopsy

Aims:

Main objective: to evaluate if ultrasound‐guided core biopsy for patients with malignant adenopathies reduces waiting times until the final diagnosis of the tumor disease. Secondary objectives are evaluated the adverse effects of the procedure, the efficiency of the same based on the adequate management of health resources and the satisfaction of patients with the technique evaluated by scales of quality of life

Methods:

We included patients with accessible adenopathies suspected of malignancy, evaluated by hematology in the period of Mar/Dec 2018.The data collected by anamnesis are: epidemiological (sex/age), anatomical region of the adenopathic conglomerate, waiting time (days) until the definitive diagnosis, the causes of inconclusive results and the adverse effects of the procedure. An economic evaluation of the health resources was made, based on the non‐request of consultations with other specialists(mainly anesthesia/surgery)and operating room time.All patients received an internal quality of life survey where satisfaction with the technique and subjective aspects related to waiting until diagnosis were evaluated.All data were compared with a historical cohort (2014/2017) for similar patients who had been studied by excisional biopsy in our hospital

Results:

31 patients were included (corresponds to 49.6% of core biopsy of the total number of patients that required a biopsy).91% was cost‐effective(definitive histological diagnosis)and there was no need to resort to a new biopsy or to invasive procedures (excision surgery).The invalid samples (in which the diagnosis could not be confirmed) were 9%(n = 3)and the cause was by insufficient sample and in no case was due to a failure of the technique. The mean time (days) until the diagnosis was 8 days vs. 30 days,in the diagnoses by excision biopsy,according to the data reviewed by our center in the 2014/2017 period for similar patients. In terms of quality of life, saving time implies a better quality of medical care, since scheduled treatments (chemotherapy)can be started in less time and greater satisfaction by avoiding the ”personal and family deterioration“ that the patient suffers while waiting for the oncological diagnosis. Optimization of health resources the consultations avoided were: 28 anesthesia, 28 surgery, 11 cardiology, 8 pneumology and surgery times for minor surgery for 28 patients

Summary/Conclusion:

Ultrasound‐guided core biopsy (trucut) is a valid and recommended diagnostic alternative for patients with accessible lymph nodes suspected of malignancy. It shortens the time of diagnosis, improves the prognosis and is a safe procedure, without medical complications and without the anesthetic/surgical risk that exists with the usual excision techniques, improving secondarily the quality of life and health resources.

A greater number of patients, which we will include in the coming months, as well as a greater experience in the realization of the technique, will reinforce these results and will be updated in the next congress