Role of Repeat Core Needle Biopsy After Nondiagnostic Initial Biopsy for Soft Tissue and Bone Sarcoma: Systematic Review and Meta‐Analysis

Core needle biopsy (CNB) is the preferred diagnostic method for suspected soft tissue and bone sarcoma, but nondiagnostic results remain common. To clarify the role of repeat biopsy, we conducted a systematic review of studies reporting repeat CNB after an initial nondiagnostic CNB, searching MEDLINE, EMBASE and PubMed. Nine studies involving nearly 9757 initial CNBs were included. Meta-analysis showed a pooled diagnostic yield of 69% (95% CI: 0.564-0.819) for repeat CNB. Subgroup analyses demonstrated a significantly higher diagnostic yield in bone sarcoma (83.1%) compared with soft tissue sarcoma (48.5%). The repeat CNB rate following a nondiagnostic initial biopsy was 5.48%. This study represents the first systematic review and meta-analysis evaluating repeat CNB in this setting, and it highlights substantial variability in diagnostic yield between sarcoma subtypes. Further research focusing on repeat biopsy across specific sarcoma subgroups is warranted to guide clinical decision-making.