Newer reconstruction techniques enabled surgeons to achieve local control and satisfactory long-term survival in patients with pelvic tumors, but the resulting complication rates were high, according to study findings.
Researchers retrospectively identified 129 patients who underwent limb-salvage with pelvic resection for bone tumors between 1990 and 2009 and had a mean 6.3 years of follow-up. Seventy-six patients were male, and patients’ mean age was 43.7 years. The most frequently observed histotype was chondrosarcoma.
Among the cases analyzed, 31 had no acetabular involvement and were reconstructed with allograft only. Cases requiring acetabular resection involved reconstruction with allograft prosthetic composite, allograft only, trabecular metal components, prosthesis only, saddle prosthesis or iliofemoral arthrodesis.
The researchers reviewed pathologic materials; imaging study data; and information pertaining to patients’ clinical characteristics, treatment and outcomes. Additionally, medical records were reviewed to determine causes of implant failure and instances of complications, were classified as intraoperative, early (within 6 months postoperatively) and late (more than 6 months postoperatively).
After surgery, 75 patients were continuously disease-free, six were disease-free after treatment, 13 were alive with the disease, 28 patients had died from disease and five had died for other reasons. At 5 years, patients’ overall survival rate was 75%, compared with 66% at 10 years.
According to the researchers, surgical resection of a malignant tumor was wide in 92 patients, wide but contaminated 20 patients, marginal in six patients and intralesional in four patients. Overall, there was a 32.8% metastasis rate in patients with malignant tumors, and there was a 22.1% local reoccurrence rate. However, the researchers did not observe any correlation between the reoccurrence of tumors and the margins or tumor site.
Thirty patients had deep infection, the most common complication at 25-month follow-up. Due to disease reoccurrence and infection, 16 patients had to undergo hemipelvectomy. – by Monica Jaramillo
Disclosures: The researchers report no relevant financial disclosures.