Introduction: Sterotactic biopsy (with or without frame guidance) is a mainstay of neuro-oncology practice, allowing for histological diagnosis to be made for those tumours whose anatomy precludes aggressive debulking, or those patients whose physiology may not warrant a more aggressive procedure. Our standard practice is to perform frameless stereotactic biopsy with intra-operative smears reported on site. We undertook a retrospective review to review the mortality and efficacy of our approach.
Methods: 465 consecutive stereotactic biopsies were examined from the period 2006-2011 as part of a retrospective chart review.
Results: 238 Glioblastomas, 93 other astrocytomas and 62 Lymphomas were diagnosed, with 59 other less frequent diagnoses as well. In thirteen patients we were unable to reach a definitive diagnosis. 7 day mortality was 6/465 (1.2%), rising to 9.5% at 30 days. 30 day Mortality was greatly increased in those patients with GBM (13%) and Lymphoma (14.5%) as opposed to any other diagnosis (2.4%).
Conclusions: We noted a 3% non-diagnostic rate for our biopsies. Mortality was surprisingly high, but the marked skew towards patients with Glioblastoma and Lymphoma probably reflects the nature of the disease and the patient population. The mortality of 1.2% at seven days is probably a more accurate reflection of the procedural risk. Regardless, all this information is useful when it comes to counselling our patients about the relative risks of a procedure.
Patient Care: This work serves as a large audit of a tertiary neuro-oncology service and the efficacy of our biopsy programme. This knowledge allows for better informed patients throughout the entire process.
Learning Objectives: Participants will be able to quantify the risks involved in stereotactice biopsy, and use this information to appropriately counsel patients.