Clin Orthop Surg.  2010 Sep;2(3):160-166. 10.4055/cios.2010.2.3.160.

Outcome after Surgical Treatment of Pelvic Sarcomas

• Han I
• Lee YM
• Cho HS
• Oh JH
• Lee SH
• Kim HS

• KMID: 999435
• DOI: http://doi.org/10.4055/cios.2010.2.3.160

Abstract

BACKGROUND
We present here the oncological and functional outcomes of limb salvage with or without reconstruction for primary sarcomas in the pelvic bone.
METHODS
Forty-four patients who underwent pelvic resection for primary sarcomas involving the pelvis were reviewed. The average follow-up period was 39 months (range, 0 to 146 months). Chondrosarcoma (n = 17) and osteosarcoma (n = 10) were the most common diagnoses. Various clinicopathologic factors were analyzed in relation to the oncological outcomes of overall survival and local recurrence. The Musculoskeletal Tumor Society functional scores and complications were compared according to the tumor location, pelvic continuity and the type of resection.
RESULTS
The overall 5-year survival rate was 40%. Metastasis at the time of diagnosis, the surgical margin and the histologic grade were the independent prognostic factors for survival. The surgical margin was an independent prognostic factor for local recurrence. An ischiopubic location of the tumor, restoration of pelvic continuity and hip joint reconstruction with total hip replacement arthroplasty were related with higher functional scores. Complications occurred in 50% of the patients and the complications varied according to the tumor location with infection being the most common complication.
CONCLUSIONS
Achieving an adequate surgical margin is necessary for improving the oncological outcome of pelvic sarcomas. Restoration of the pelvic continuity and the hip joint improves the functional outcome. However, complications are common and so careful selection of the reconstruction method is needed.

Keyword

Pelvis; Sarcoma; Reconstruction; Survival; Function

MeSH Terms

Adolescent
Adult
Aged
Bone Neoplasms/mortality/pathology/*surgery
Chemotherapy, Adjuvant
Child
Female
Humans
Limb Salvage
Male
Middle Aged
Neoplasm Recurrence, Local
*Pelvic Bones/surgery
Prognosis
Radiotherapy, Adjuvant
Sarcoma/mortality/pathology/secondary/*surgery
Survival Rate
Young Adult

Figure

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  Fig. 1 Musculoskeletal Tumor Society functional scores according to the restoration of pelvic continuity.

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