Surgical treatment of pelvic chondrosarcoma involving periacetabulum

Guo, Wei; Li, Dasen; Tang, Xiaodong; Ji, Tao

doi:10.1002/jso.21442

Cited by 53 publications

(62 citation statements)

References 28 publications

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“…Higher pathological grade is correlated with the development of distant metastasis, which also worsens the prognosis for survival, and tumor stage was identified as another important independent risk factor. Such a trend further demonstrates the importance of early diagnosis, inasmuch as detection of CS originating in the pelvis is prone to delay because the early symptoms are vague …”

Section: Discussionsupporting

confidence: 88%

Prognostic nomograms to predict overall survival and cancer‐specific survival in patients with pelvic chondrosarcoma

et al. 2019

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Background The pelvis is the most common site of chondrosarcoma (CS), and the prognosis for patients with pelvic CS is worse than that for patients with CS in the extremities. However, clinicians have had few tools for estimating the likelihood of survival in patients with pelvic CS. Our aim was to develop nomograms to predict survival of patients with pelvic CS. Methods Data from the Surveillance, Epidemiology, and End Results (SEER) database of patients with pelvic CS between 2004 and 2016 were retrieved for retrospective analysis. Univariate and multivariate Cox analyses were used to identify independent prognostic factors. On the basis of the results of the multivariate analyses, nomograms were constructed to predict the likelihood of 3‐ and 5‐year overall survival (OS) and cancer‐specific survival (CSS) of patients with pelvic CS. The concordance index (C‐index) and calibration curves were used to test the models. Results In univariate and multivariate analyses of OS, sex, pathologic grade, tumor size, tumor stage, and surgery were identified as the independent risk factors. In univariate and multivariate analyses of CSS, pathologic grade, tumor size, tumor stage, and surgery were identified as the independent risk factors. These characteristics except surgery were integrated in the nomograms for predicting 3‐ and 5‐year OS and CSS, and the C‐indexes were 0.758 and 0.786, respectively. Conclusion The nomograms precisely and individually predict OS and CSS of patients with pelvic CS and could aid in personalized prognostic evaluation and individualized clinical decision‐making.

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Section: Discussionsupporting

confidence: 88%

Prognostic nomograms to predict overall survival and cancer‐specific survival in patients with pelvic chondrosarcoma

et al. 2019

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“…The 20% infection rate in our series of patients is lower than reported rates in some series [3,4,18,26,27,36,39,41,45,46] and greater or comparable to the experience reported in other studies [1,8,12,13,19,20,29,30,38] ( Table 3). The overall infection rate in many series varied from 10% to 47% after internal hemipelvectomy [1, 3, 4, 8, 10, 12, 13, 18-20, 23, 25-27, 29, 30, 34, 36, 38-41, 45, 46], whereas it ranged from 11% to 38% in patients who had resection and endoprosthetic reconstruction [1,3,12,19,20,26,27,36,45,46]. Abudu et al [3] reported a 26% infection rate in a series of 35 patients undergoing endoprosthetic reconstruction with saddle prostheses.…”

Section: Discussionsupporting

confidence: 78%

Infection After Surgical Resection for Pelvic Bone Tumors: An Analysis of 270 Patients From One Institution

Angelini

Drago

Trovarelli

et al. 2014

Clinical Orthopaedics &Amp; Related Research

129

122

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Background Surgical treatment of pelvic tumors with or without acetabular involvement is challenging. Primary goals of surgery include local control and maintenance of good quality of life, but the procedures are marked by significant perioperative morbidity and complications. Questions/purposes We wished to (1) evaluate the frequency of infection after limb salvage surgical resection for bone tumors in the pelvis; (2) determine whether infection after these resections is associated with particular risk factors, including pelvic reconstruction, radiotherapy or chemotherapy, type of resection, and age; and (3) analyze treatment of these infections, particularly with respect to the need of additional surgery or hemipelvectomy. Methods From 1975 to 2010, 270 patients with pelvic bone tumors (149 with chondrosarcoma, 40 with Ewing's sarcoma, 27 with osteosarcoma, 18 with other primary malignant tumors, 11 with metastatic tumors, and 25 with primary benign tumors) were treated by surgical resection.Minimum followup was 1.1 years (mean, 8 years; range, 1-33 years). The resection involved the periacetabular area in 166 patients. In 137 patients reconstruction was performed; in 133 there was no reconstruction. Chart review ascertained the frequency of deep infections, how they were treated, and the frequency of resection arthroplasty or hemipelvectomies that occurred thereafter. Results A total of 55 patients (20%) had a deep infection develop at a mean followup of 8 months. There were 20 infections in 133 patients without reconstruction (15%) and 35 infections in 137 patients with reconstruction (26 %). Survivorship rates of the index procedures using infection as the end point were 87%, 83%, and 80% at 1 month, 1 year, and 5 years, respectively. Infection was more common in patients who underwent pelvic reconstruction after resection (univariate analysis, p = 0.0326; multivariate analysis, p = 0.0418; odds ratio, 1.7718; 95% CI, 1.0243-3.0650); no other risk factors we evaluated were associated with an increased likelihood of infection.

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“…With the advancement of preoperative adjuvant treatments, improvements in imaging and surgical techniques, and the development of oncologically correct limb-salvage procedures, indications for hemipelvectomy in patients with pelvic malignancies have decreased dramatically [5-7]. However, in rare and complicated cases, amputation is still an option for this patient population [8].…”

Section: Introductionmentioning

confidence: 99%

Femur performed better than tibia in autologous transplantation during hemipelvis reconstruction

Mei

Gao

et al. 2014

World J Surg Onc

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BackgroundPelvic reconstruction after hemipelvectomy can greatly improve the weight-bearing stability of the supporting skeleton and improve patients’ quality of life. Although an autograft can be used to reconstruct pelvic defects, the most suitable choice of autograft, i.e., the use of either femur or tibia, has not been determined. We aimed to analyze the mechanical stresses of a pelvic ring reconstructed using femur or tibia after hemipelvectomy using finite element (FE) analysis.MethodsFE models of normal and reconstructed pelvis were established based on computed tomography images, and the stress distributions were analyzed under physiological loading from 0 to 500 N in both intact and restored pelvic models using femur or tibia.ResultsThe vertical displacement of the intact pelvis was less than that of reconstructed pelvis, but there was no significant difference between the two reconstructed models. In FE analysis, the stress distribution of the intact pelvic model was bilaterally symmetric and the maximum stresses were located at the sacroiliac joint, arcuate line, ischiatic ramus, and ischial tuberosity. The maximum stress in each part of the reconstructed pelvis greatly exceeded that of the intact model. The maximum von Mises stress of the femur was 13.9 MPa, and that of the tibia was 6.41 MPa. However, the stress distribution was different in the two types of reconstructed pelvises. The tibial reconstruction model induced concentrated stress on the tibia shaft making it more vulnerable to fracture. The maximum stress on the femur was concentrated on the connections between the femur and the screws.ConclusionsFrom a biomechanical point of view, the reconstruction of hemipelvic defects with femur is a better choice.

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Surgical treatment of pelvic chondrosarcoma involving periacetabulum

Abstract: Favorable oncological and functional outcome can be achieved in selected patients with periacetabular chondrosarcomas. The complication rates were still high; however, facing the goal of limb salvage, a certain number of complications is acceptable.

Cited by 53 publications

References 28 publications

Prognostic nomograms to predict overall survival and cancer‐specific survival in patients with pelvic chondrosarcoma

Prognostic nomograms to predict overall survival and cancer‐specific survival in patients with pelvic chondrosarcoma

Infection After Surgical Resection for Pelvic Bone Tumors: An Analysis of 270 Patients From One Institution

Femur performed better than tibia in autologous transplantation during hemipelvis reconstruction

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