Morbidity and functional status of patients with pelvic neurogenic tumors after wide excision.
BACKGROUND
We previously reported that over the last 10 years our practice has evolved in the treatment of neurogenic tumors of the pelvis to include a multispecialty team of surgeons, a factor that might decrease morbidity and improve recurrence, survival, and function.


OBJECTIVE
Therefore, we (1) assessed the morbidity associated with surgical excision in patients with neurogenic tumors of the pelvis; (2) determined the function of these patients; and (3) determined the rates of local recurrence, metastasis, and overall survival with this new approach.


METHODS
We reviewed the records of all 38 patients who had surgery for a pelvic plexus tumor between 1994 and 2005. Twenty one were male. The mean age of all patients was 38 years and median follow up was 2.1 years. Twelve patients had a malignant tumor. We recorded demographic data, postoperative complications, tumor-specific recurrence, and determined survival.


RESULTS
Postoperative complications occurred in nine of the 38 patients (23%): hematoma (n = 3), wound infection or deep abscess (n = 3), and deep venous thrombosis (n = 3). Surgical complications occurred more frequently in patients with malignant disease. Patients with benign tumors had a mean MSTS score of 94%, while survivors of malignant disease had a mean of 57%. For malignant tumors, the 5-year rate of local recurrence was 40%, the estimated 5-year rate of metastasis was 67% and 5-year survival rate was 50%.


CONCLUSIONS
Using a team approach, surgical excision provided high functional scores for patients with benign disease with a low rate of complications. In patients with malignant tumors, intentional wide resection is associated with higher morbidity but yields acceptable functional scores.
Alderete
Joseph
J
Department of Orthopedic Surgery, Mayo Clinic, 200 First, SW, Rochester, MN 55905, USA.
Novais
Eduardo N
EN
Dozois
Eric J
EJ
Rose
Peter S
PS
Sim
Franklin F
FF
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D009364:Neoplasm Recurrence, Local; D009380:Neoplasms, Nerve Tissue / Q000401:mortality / Q000503:physiopathology / Q000556:secondary / Q000601:surgery*; D019637:Orthopedic Procedures / Q000009:adverse effects; D010384:Pelvic Bones / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D012189:Retrospective Studies; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult