Resection And Functional Reconstruction For Bone Tumors Of Pelvic

Objective:Pelvic tumors are relatively rare, the majority of which were malignant. Because of difficult to early diagnose, their volume often huge when discovered. Although surgical treatment is the main treatment method, nearly all of surgeons see it difficult. In order to get the best lower-limb function based on the radical tumor resection, most experts tend to tumor resection and reconstruction limb-sparing treatment. We retrospectively reviewed clinical data of 27 pelvic tumor patients who undergone limb-sparing treatment from January 2005 to September 2015 in our department, in order to discuss pelvic tumor resection and reconstruction and to evaluate their treatment effects. Methods:27 cases with pelvic tumors were treated with limb-sparing surgery during January 2005 to September 2015, 15 cases of men and 12 cases of women, whose age from 12 to 78. Among this cases, there were 10 benign tumors, 15 malignant tumors and 2 metastatic tumors derived from other primary tumor. According to Enneking’s division, they 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, 2 cases in region Ⅰ+Ⅳ. We choosed excision or curettage combined with bone grafting or bone cement filling for benign tumors, we also used internal fixation if necessary. For malignant tumors, radical resection were used. When pelvic ring continuity or acetabulum was destroyed, we gave reconstruction. Local recurrence, distant metastasis and limb function were followed-up postoperatively on a regular basis. Hip joint function was evaluated through ISOLS scores when acetabulum was reconstructed. Survival rate was calculated by Kaplan-Meier method. Results:No peri-operative death cases. All of them were followed-up 4 to 125 months. Local recurrence in 1 case(10.0%) was found in benign patients. 8 cases(47.1%) in 17 malignant patients were dead, 5 cases(29.4%) dead of local recurrence, 2 cases(11.8%) dead of uncontrolled lung metastasis, 1 case(5.9%) dead of primary disease. Malignant patients survival rate was calculated by Kaplan-Meier method. The 1-year survival rate was 75.6%, the 2-year survival rate was 61.9%, 3-year and 5-year survival rate were 43.3%. As for the functional recovery, tumor resection or reconstruction cases with region in Ⅰ, Ⅲ or Ⅳ basically recovered lower-limb function, cases with region in Ⅱ needed one crutche to assist walking. Their ISOLS scores during 18-29. Conclusion:Selecting suitable resection or reconstruction methods according to the histology and the location of pelvic tumors do good to achieve best results, surgical methods need to individualize.