Outcome after surgical treatment of pelvic sarcomas.
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.
Han
Ilkyu
I
Department of Orthopedic Surgery, Seoul National University College of Medicine, Seoul, Korea.
Lee
Young Min
YM
Cho
Hwan Seong
HS
Oh
Joo Han
JH
Lee
Sang Hoon
SH
Kim
Han-Soo
HS
D000293:Adolescent; D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D017024:Chemotherapy, Adjuvant; D002648:Child; D005260:Female; D006801:Humans; D023821:Limb Salvage; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010384:Pelvic Bones / Q000601:surgery; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult
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