title: Modular hemipelvic endoprosthesis reconstruction--experience in 100 patients with mid-term follow-up results.
abstract: BACKGROUND
  Pelvic endoprostheses are becoming more commonly used in recent years. In 2007, we reported the early results of modular hemipelvic endoprosthesis. In order to provide longer follow-up results, we conducted the current study.
  
  
  OBJECTIVE
  To explore overall survival, local recurrence rate, metastasis rate, function score and survivorship of the prosthesis and related complications.
  
  
  METHODS
  We retrospectively reviewed one hundred consecutive patients who received reconstruction with modular hemipelvic endoprostheses from June 2001 to March 2010. The living patients were followed for an average of 52.9 (range, 24-103) months. There were 85 primary tumors and 15 isolated metastases.
  
  
  RESULTS
  At the time of last follow-up, fifty-eight patients were alive with no evidence of disease and thirty-six patients died of disease. Twenty patients experienced a local recurrence and twenty-eight patients developed distant metastasis. Patients with wide surgical margins had a significantly lower local recurrence rate than those with inadequate margins (p = 0.03). The mean MSTS (Musculoskeletal Tumor Society) 93 score was 57.2% (range, 16.7-86.7%). The mean Karnofsky Performance Score (KPS) was 64.4 (range, 30-90). Postoperative complications occurred in 45% of the patients. Wound healing disturbance (18%) and deep infection (15%) were the most predominant. Less frequent complications included dislocation, which occurred in nine patients and mechanical complications including 5 breakages and 2 aseptic loosening.
  
  
  CONCLUSIONS
  The modular hemipelvic endoprosthesis can provide a versatile reconstruction option for a variety of pelvic defects with an acceptable rate of complication. Wide margins whenever possible should be the goal for these complex patients.
authors.affiliation: Musculoskeletal Tumor Center, People's Hospital, Peking University, Xizhimen Nan 11#, Xicheng District, Beijing 100044, China.
authors.forename: T
authors.initials: T
authors.lastname: Ji
authors.forename: W
authors.initials: W
authors.lastname: Guo
authors.forename: R L
authors.initials: RL
authors.lastname: Yang
authors.forename: X D
authors.initials: XD
authors.lastname: Tang
authors.forename: Y F
authors.initials: YF
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D001859:Bone Neoplasms / Q000473:pathology / Q000601:surgery*; D002681:China / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D017567:Karnofsky Performance Status; D023821:Limb Salvage; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D010384:Pelvic Bones / Q000473:pathology* / Q000601:surgery*; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D012189:Retrospective Studies; D012509:Sarcoma / Q000556:secondary / Q000601:surgery*; D016896:Treatment Outcome