title: Oncologic and clinical outcomes in pelvic primary bone sarcomas treated with limb salvage surgery.
abstract: OBJECTIVE
  We propose to study a group of patients with primary bone sarcoma of the pelvis treated with limb salvage surgery and analyze overall survival, local recurrence rates and functional outcomes.
  
  
  METHODS
  A retrospective review was performed, and all patients diagnosed with pelvic primary bone sarcomas between 1990 and 2012 were analyzed. Patients treated with limb salvage surgery and with a minimum of 12-month follow-up for patients alive were included. The overall survival and the local recurrence rate were calculated for the assessment of oncological results. The associations with gender, age, histological grade, type of surgery, margins chemotherapy response and use of navigation were examined.
  
  
  RESULTS
  Fifty-two patients were included in the study. The mean age was 37 years (range 10-82), and mean follow-up was 44 months (range 8-189). Forty-five (86 %) tumors were histologically classified as high-grade sarcomas, four (8 %) as low-grade sarcomas and three (6 %) as dedifferentiated sarcomas. Cancer-specific overall survival was 37.5 % for 5 years and 31 % for 10 years. Local recurrence rate was 30 %. High-grade tumors and chemotherapy necrosis below 90 % were negative prognosis factor. Postoperative complication rate was 34.5 % (n:18), being deep infection the most prevalent (n:13). Reconstruction of the pelvis after an oncology resection for primary pelvic sarcomas increased the incidence of complication significantly (p < 0.001).
  
  
  CONCLUSIONS
  Primary bone sarcomas involving the pelvis are suggestive of a high-grade tumor and present poor oncologic outcomes. Pelvic reconstruction after a limb salvage surgery is associated with a high risk of complication.
  
  
  METHODS
  Case series, Level IV.
authors.affiliation: Hospital Italiano de Buenos Aires. Carlos E. Ottolenghi Institute of Orthopedics, Potosí 4247, C1199ABD, Buenos Aires, Argentina.
authors.forename: G L
authors.initials: GL
authors.lastname: Farfalli
authors.affiliation: Hospital Italiano de Buenos Aires. Carlos E. Ottolenghi Institute of Orthopedics, Potosí 4247, C1199ABD, Buenos Aires, Argentina. nachoalbergo@hotmail.com.
authors.forename: J I
authors.initials: JI
authors.lastname: Albergo
authors.affiliation: Hospital Italiano de Buenos Aires. Carlos E. Ottolenghi Institute of Orthopedics, Potosí 4247, C1199ABD, Buenos Aires, Argentina.
authors.forename: L E
authors.initials: LE
authors.lastname: Ritacco
authors.affiliation: Hospital Italiano de Buenos Aires. Carlos E. Ottolenghi Institute of Orthopedics, Potosí 4247, C1199ABD, Buenos Aires, Argentina.
authors.forename: M A
authors.initials: MA
authors.lastname: Ayerza
authors.affiliation: Hospital Italiano de Buenos Aires. Carlos E. Ottolenghi Institute of Orthopedics, Potosí 4247, C1199ABD, Buenos Aires, Argentina.
authors.forename: D L
authors.initials: DL
authors.lastname: Muscolo
authors.affiliation: Hospital Italiano de Buenos Aires. Carlos E. Ottolenghi Institute of Orthopedics, Potosí 4247, C1199ABD, Buenos Aires, Argentina.
authors.forename: L A
authors.initials: LA
authors.lastname: Aponte-Tinao
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D017024:Chemotherapy, Adjuvant / Q000379:methods; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D023821:Limb Salvage / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000401:mortality / Q000601:surgery*; D012516:Osteosarcoma / Q000601:surgery*; D010384:Pelvic Bones / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Limb salvage surgery; Pelvic sarcomas; Survival; Virtual navigation