Abstract
PurposeTo evaluate the effectiveness of reconstruction with a modular hemipelvic endoprosthesis after pelvic tumor resection.MethodsWe retrospectively studied 50 consecutive patients diagnosed with pelvic tumor from 2003 to 2013. All patients received limb-salvage surgery and reconstruction with modular hemipelvic endoprosthesis.ResultsPatients were followed for an average of 54 months. At the most recent follow-up, 32 patients were alive with an estimated three-year and five-year survival rate of 66.3% and 57.5% according to the Kaplan-Meier survival analysis. Eighteen patients died from the tumor, with a mean survival of 28 months, and 9 patients experienced local recurrence at an average of 19.6 months after surgery. Patients with marginal or intracapsular surgical margins had a significantly higher recurrence rate than those with wide margins (p=0.02). Metastasis occurred in 12 cases at an average of 16 months after surgery. The perioperative complication rate was 48.0%, and the most common complications were wound healing disturbance (28.0%) and deep infection (14.0%). The endoprosthetic complication rate was 16.0%, and breakage of the pubic connection plate was the most common complication. The mean Musculoskeletal Tumor Society score was 61.4%.ConclusionReconstruction with a modular hemipelvic endoprosthesis after pelvic tumor resection can improve function, with an acceptable complication rate.
Highlights
Pelvic tumors, malignant tumors, greatly impact patients’ survival and quality of life
At the most recent follow-up, 32 patients were alive with an estimated three-year and five-year survival rate of 66.3% and 57.5% according to the Kaplan-Meier survival analysis
Limb-salvage surgery with endoprosthetic replacement or biological reconstruction is favored by patients over classic hemipelvectomy[1,2,3,4]
Summary
Malignant tumors, greatly impact patients’ survival and quality of life. The reconstruction of pelvic bone defects in orthopedic oncology remains challenging, when the hemipelvis is considerably involved. Limb-salvage surgery with endoprosthetic replacement or biological reconstruction is favored by patients over classic hemipelvectomy[1,2,3,4]. Biological reconstruction, such as autografts, allografts, iliofemoral and ischiofemoral arthrodesis, are limited by extended bone and soft tissue defects and result in high complication rates and poor limb function[5,6,7]. The variety of prosthetic designs, combined with insufficient follow-up data and high complication rates makes hemipelvic endoprosthetic reconstruction controversial
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