Outcomes of pelvic resection from malignant pelvic tumors. A case series

Introduction: Malignant pelvic tumors also tend to present late and therefore pose a major challenge for orthopedic oncologists because of the large tumor size, local extension, and complex anatomy with proximity to major neurovascular structures and intestinal and urinary tracts. Method: We evaluated the oncologic, functional outcome and complications following internal hemipelvectomy in a consecutive series of patients with malignant muculoskeletal tumors of the pelvis at our hospital between January 2012 and December 2017. The follow-up period was defined as the length of time elapsed from the date of surgery until the death or last date of review following operation. We analyzed survival rate using Kaplan Meier method and it relation with tumor site, tumor size, and type of histology. Result: Our clinical series of patients were composed of 4 males and 5 females. Of 9 patients, 6 cases were primary malignant bone tumor (3 cases of chondrosarcoma, 2 cases of osteosarcoma, and 1 case of Ewing's sarcoma), 2 cases of metastatic bone disease from thyroid carcinoma, 1 case from breast adenocarcinoma. The Kaplan Meier analysis showed 1 year and 2 years survival rate were 88.9% and 66.7% respectively. The functional outcomes showed the mean MSTS score 16.5 point. The lowest score was 9, which was pelvis resection type I + II on osteosarcoma case. The highest score was 25, which was pelvic resection type II + III and reconstruted with iliofemoral arthrodesis. There was 1 case intraoperative bleeding and 2 cases post operative infections. Conclusions: The majority of pelvic tumor underwent pelvic resection is chondrosarcoma. Functional outcome MSTS score was still comparable with previous study. Complications of pelvic surgeries were bleeding and infection. In our small case series, pelvic resection with wide margin and reconstruction of bone defect may give good local control and clinical outcome.