Resection and functional reconstruction of pelvic tumors

Abstract

Objective To discuss the method of resection and reconstruction and effects in pelvic tumors. Methods The data of 27 cases with pelvic tumors treated with limb-salvage surgery during January 2005 to September 2015 were retrospective analyzed, including 15 males and 12 females, with age from 12 to 78 years old. Among these cases, there were 10 benign tumors, 1 borderline tumor, 14 malignant tumors and 2 metastatic tumors derived from other primary tumors. According to Enneking's division, it was consisted of 14 cases in region Ⅰ, 2 cases in region Ⅱ, 6 cases in region Ⅲ, 2 cases in region Ⅰ+Ⅱ, 1 cases in region Ⅱ+Ⅲ and 2 cases in region Ⅰ+Ⅳ. Excision or curettage were chosen for benign tumors, and bone grafting or bone cement filling internal fixation were also used if necessary. For borderline and malignant tumors, radical resection was performed, meanwhile, reconstruction was done when pelvic ring continuity or acetabulum was destroyed, and palliative surgery was performed in some patients. All of them were followed-up 4-125 months. Results There was no perioperative death. Among 10 benign patients, 1 case (10.0%) of local recurrence was found. 8 (47.1%) patients in 17 borderline and malignant patients were dead, including 5 cases(29.4%) dead of local recurrence, 2 cases(11.8%) dead of uncontrolled lung metastasis and 1 case(5.9%) dead of primary disease. According to Kaplan-Meier method, the 1-, 2-, 3- and 5-year survival rates of borderline and malignant patients were 75.6%, 61.9%, 43.3% and 43.3%, respectively. As for the functional recovery, the lower-limb fuction of patients treated by resection or reconstruction in region Ⅰ, Ⅲ or Ⅳ got basically recovered, and the patients in region Ⅱ needed one crutch to assist walking. Conclusion Selecting suitable resection or reconstruction methods according to the histology and the location of pelvic tumors can get favorable effects, furthermore, surgical methods need to individualize. Key words: Bone neoplasms; Pelvic; Limb-salvage treatment; Reconstruction