Outcomes after limb sparing resection in primary malignant pelvic tumors

Puri, Ajay; Pruthi, Manish; Gulia, Ashish

doi:10.1016/j.ejso.2013.10.017

Cited by 48 publications

(41 citation statements)

References 29 publications

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“…28 The reconstructive options include endoprosthetic reconstruction, 23,[29][30][31][32][33][34][35][36][37] biological reconstruction using allograft 38,39 or autograft, [40][41][42][43][44] iliofemoral arthrodesis, 24,45 or hip transposition arthroplasty. 28,46,47 The high complication rate is a major problem of these reconstructive procedures except for hip transposition arthroplasty, which includes superficial/deep infection, dislocation, neurovascular and visceral damage, mechanical and structural failure, and wound dehiscence/necrosis, 24,25,29,32,[48][49][50] and these complications are associated with poor functional outcomes. 23,24 Hip transposition arthroplasty reportedly has fewer complications and re-operations than the other surgical procedures.…”

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confidence: 99%

Surgical treatment for pelvic Ewing sarcoma: What is a safe and functional acetabular reconstruction when combined with modern multidisciplinary treatments?

Fujiwara

Lex

Stevenson

et al. 2019

Journal of Surgical Oncology

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Purpose The purpose of this study was to clarify which local treatment is oncologically and functionally effective in pelvic Ewing sarcoma (ES). Methods A consecutive series of patients who underwent pelvic resections and acetabular reconstructions after chemotherapy between 1986 and 2016 at a supra‐regional center were evaluated. Results The cohort consisted of 35 patients. The 5‐year overall survival (OS) and local recurrence‐free survival (LRFS) was 61% and 72%, respectively. Preoperative radiotherapy (RT) and surgery provided an excellent/good histological response in 92% and achieved significantly better OS (5 years, 64%) and LRFS (5 years, 100%) than surgery alone or surgery with postoperative RT. The Musculoskeletal Tumor Society functional scores were significantly better in patients with hip transposition than those with structural reconstructions (74% vs 57%; P = .031) using custom‐made prostheses, irradiated autografts, and ice‐cream cone prostheses. These scores were significantly lower if patients had deep infection (P = .035), which was the most common complication (28%) in structural reconstructions but did not occur in hip transposition even when performed after preoperative RT. Conclusion Acetabular reconstruction with hip transposition resulted in no deep infection and superior function in patients with pelvic ES even when combined with preoperative RT, which improved tumor necrosis and rate of local control and survival.

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confidence: 99%

Surgical treatment for pelvic Ewing sarcoma: What is a safe and functional acetabular reconstruction when combined with modern multidisciplinary treatments?

Fujiwara

Lex

Stevenson

et al. 2019

Journal of Surgical Oncology

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“…The small numbers in this series may be considered as a limitation by some. Osteosarcomas of the pelvis are uncommon lesions and the fact that only 12 cases were operated in an 8 year period from a tertiary cancer hospital with a wide experience of managing pelvic malignancies bears testimony to that fact 22. Similarly, a high volume globally recognized European center documented the results of only 22 primary high grade pelvic osteosarcomas over a 25 year period 4…”

Section: Discussionmentioning

confidence: 99%

Outcome of surgical resection of pelvic osteosarcoma

Puri

Gulia

Pruthi

2014

IJOO

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Background:The aim of the following study is to evaluate the morbidity, oncologic results and functional outcome in nonmetastatic patients with primary osteosarcoma of the pelvis treated with surgical resection.Materials and Methods:Twelve cases of nonmetastatic osteosarcoma of pelvis were operated as part of their multimodality treatment regime between November 2003 and May 2011. There were 5 males and 7 females with a median age of 22 years (range 8-39 years). Ten patients underwent limb sparing resections while 2 had a hindquarter amputation. All 10 cases of limb sparing surgery included resection of the acetabulum. A pseudarthrosis was carried out in 7 cases. Extracorporeal radiation therapy and reimplantation of the bone followed by fixation with plates was used in 1 case and an ischiofemoral arthrodesis was carried out in 2 cases.Results:Surgical margins were free in 11 patients. Seven patients had a poor histological response to chemotherapy while 4 patients had a good response to chemotherapy. In the patient reconstructed with radiated auto bone graft, the histological response to chemotherapy could not be assessed. Surgery related complications were seen in 8 out of 12 patients (67%). Three of these patients (25%) required additional surgical intervention for their complications. All patients were available for followup. The median followup of survivors was 56 months (range 24-102 months). Four patients (33%) developed a local recurrence. At 5 years, overall survival was 67%. Patients with a good response to chemotherapy had a better overall survival when compared with patients with a poor response to chemotherapy. The mean Musculoskeletal Tumor Society functional score was 22 (range12-27).Conclusions:Though complex and challenging, surgery provides good local control and oncologic outcomes with acceptable function in patients with osteosarcoma of the pelvis treated with appropriate surgical resection as part of their multimodality treatment.

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“…Fundamentally, iliectomy and ischiectomy are techniques to preserve the limbs when removing pelvic bone neoplasm . Internal hemipelvectomy for tumor removal with preservation of the limb has been well reported in human medicine . The Enneking classification for pelvic resection describes three types of procedures .…”

Section: Introductionmentioning

confidence: 99%

Iliectomy with limb preservation for a dog with ilial osteosarcoma: Surgical description and case report

Oramas

Boston²,

Skinner

2019

Veterinary Surgery

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Objective To report the surgical technique for iliectomy and outcome in a single clinical case. Study design Case report. Animal A 10‐year‐old female spayed Rottweiler. Methods A dog presented with left pelvic limb lameness due to a mass involving the left ilium. Fine needle aspirates were indicative of a sarcoma and suspicious for osteosarcoma. Computed tomography of thorax, abdomen, and pelvis was performed as well as skeletal scintigraphy, with no evidence of metastasis seen. The dog underwent iliectomy with preservation of the ipsilateral limb and was ambulatory 24 hours after surgery. Results of histopathology confirmed the diagnosis of an osteosarcoma. Results A right ischial fracture was noted 8 days postoperatively and was conservatively managed. Local recurrence was reported 385 days postoperatively, with no overt metastatic disease revealed by computed tomography of the thorax and abdomen. The dog was euthanized because of local recurrence 430 days after surgery. Conclusion Iliectomy was well tolerated in this dog and afforded good function of the pelvic limbs. Local recurrence developed with no evidence of metastasis at the last follow‐up. Iliectomy can be considered for a mass confined to the ilium when preservation of the limb is desired. Additional studies are required to determine the local recurrence and complication rates associated with this procedure in dogs with axial skeletal osteosarcoma. Clinical significance To the authors' knowledge, this case report represents the fist surgical description and clinical outcome for an iliectomy in dogs.

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Outcomes after limb sparing resection in primary malignant pelvic tumors

Cited by 48 publications

References 29 publications

Surgical treatment for pelvic Ewing sarcoma: What is a safe and functional acetabular reconstruction when combined with modern multidisciplinary treatments?

Surgical treatment for pelvic Ewing sarcoma: What is a safe and functional acetabular reconstruction when combined with modern multidisciplinary treatments?

Outcome of surgical resection of pelvic osteosarcoma

Iliectomy with limb preservation for a dog with ilial osteosarcoma: Surgical description and case report

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