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

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. In a retrospective study, patie...

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Published in:	Clinical imaging Vol. 99; pp. 19 - 24
Main Authors:	Gingold-Belfer, Rachel, Shinhar, Nadav, Bachar, Gil N., Issa, Nidal, Boltin, Doron, Sharon, Eran, Shohat, Tzippy, Sapoznikov, Boris, Swartz, Ariel, Peleg, Noam, Konikoff, Tom, Schmilovitz-Weiss, Hemda
Format:	Journal Article
Language:	English
Published:	United States Elsevier Inc 01-07-2023
Subjects:	Aged Aged, 80 and over Female Hepatic space occupying lesion Humans Image-Guided Biopsy Liver biopsy Liver Neoplasms - pathology Male Medical futility Middle Aged Retrospective Studies Ultrasonography Liver biopsy Medical futility Hepatic space occupying lesion
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Summary:	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. 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. 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). In patients with these features or with disseminated disease, liver biopsy should be carefully reconsidered. •Percutaneous liver biopsy is mainly perforemd to find if new hepatic lesions are benign, malignant, or metastatic diseaese•We investigated the medical contribution of ultrasound-guided percutaneous liver biopsy in the diagnosis of hepatic lesions.•Clinical, laboratory and imaging data were combined with patients' outcome.•Thus, we were able to outline states in which ultrasound-guided percutaneous liver biopsy becomes medically futile.•In elders with disseminated malignancy, low albumin and high LDH, liver biopsy has no contribution to patients' outcome.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0899-7071 1873-4499
DOI:	10.1016/j.clinimag.2023.04.001