Internal hemipelvectomy with reconstruction for primary pelvic neoplasm: a systematic review.
BACKGROUND
Hemipelvectomy is a major operation with significant risks including infection, prosthesis failure and fracture. This systematic review was designed to review the functional outcomes, oncologic outcomes and complications in patients who received internal hemipelvectomy and pelvic reconstruction for primary pelvic tumour.


METHODS
Searches on MEDLINE, the Cochrane Library, Embase and Google Scholar were performed to locate studies involving patients receiving internal hemipelvectomy and pelvic reconstruction using a prosthesis, implant or bone graft. All studies were either prospective or retrospective observational studies published in English.


RESULTS
This systematic review included 12 studies from 1990 to 2011 involving 217 patients from 5 to 77 years of age who had received follow-up for a period from 3 weeks to 15 years. Among the 12 studies, the mortality rate, disease-free rate and incidence of local recurrence were 10-69.2, 23.1-90.0 and 9.1-41.7%, respectively. The post-operative Musculoskeletal Tumor Society (MSTS) functional score ranged from 50 to 70 in the more recent studies. Compared with prostheses and other implants, patients who received allografts had the highest post-operative function, as shown by their MSTS scores, but also had a greater incidence of post-operative infection. On the other hand, the prosthesis group was associated with the highest percentage of fracture and dislocations, as well as other significant complications.


CONCLUSIONS
This comprehensive review provided informative details regarding the goals, outcomes and complications associated with this procedure and underscored the need for further investigation into the various surgical approaches currently available.
Department of Orthopedics, PLA Fourth Fifty-Five Hospital (455 Hospital), Shanghai, China.
Qing Dong
QD
Shao
Department of Orthopedics, PLA Fourth Fifty-Five Hospital (455 Hospital), Shanghai, China.
Xu
X
Yan
Department of Orthopedics, PLA Fourth Fifty-Five Hospital (455 Hospital), Shanghai, China.
Jiu Yi
JY
Sun
Department of Orthopedics, PLA Fourth Fifty-Five Hospital (455 Hospital), Shanghai, China.
Tian Ming
TM
Xu
D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016025:Bone Transplantation; D006428:Hemipelvectomy; D006801:Humans; D015994:Incidence; D009364:Neoplasm Recurrence, Local; D010384:Pelvic Bones / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function
bone graft; hemipelvectomy; pelvic neoplasms; pelvic prosthesis; pelvic reconstruction