title: Preliminary experience with external hemipelvectomy for locally advanced and recurrent pelvic carcinoma.
abstract: OBJECTIVE
  Eight highly selected patients are reported, undergoing external hemipelvectomy (EHP) for malignant infiltration of the lumbosacral neural plexus.
  
  
  METHODS
  All patients were evaluated by positron emission tomography-computed tomography (PET-CT), CT and magnetic resonance imaging. No evidence of disseminated disease was found. With agreement by the multidisciplinary team, surgery was performed by a colorectal surgeon and an orthopaedic sarcoma surgeon and, if needed, by an urologist and vascular surgeon. Patients were reconstructed with either a femoral or a gluteal musculocutaneous flap.
  
  
  RESULTS
  Of the eight women [median age 54.5 (40-68) years], two had primary carcinoma and six local recurrence of a previously treated carcinoma. R0 was possible in six patients and R1 resection in two. The median duration of hospital stay was 29.5 (17-102) days. The median follow up was 8.3 (4.7-52.8) months. Three patients have died, one from postoperative complications at 5 months and two from recurrence at 5 and 52.8 months. Phantom-limb was experienced in six patients. Four patients received a prosthesis, one is considering this and one does not want a prosthesis.
  
  
  CONCLUSIONS
  Hemipelvectomy may be considered for a highly selected group of patients with locally advanced carcinoma or recurrence involving the lumbosacral neural plexus.
authors.affiliation: Department of Surgery, E, Aarhus University Hospital, Aarhus, Denmark. mette.bak.nielsen@ki.au.dk
authors.forename: M B
authors.initials: MB
authors.lastname: Nielsen
authors.forename: P
authors.initials: P
authors.lastname: Rasmussen
authors.forename: J
authors.initials: J
authors.lastname: Keller
authors.forename: S
authors.initials: S
authors.lastname: Laurberg
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology* / Q000601:surgery*; D005260:Female; D006428:Hemipelvectomy / Q000009:adverse effects; D006801:Humans; D007902:Length of Stay; D008160:Lumbosacral Plexus / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D064847:Multimodal Imaging; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000601:surgery*; D018579:Patient Selection; D010386:Pelvic Neoplasms / Q000473:pathology* / Q000601:surgery*; D010865:Pilot Projects; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome