Hip disarticulation for non-salvageable primary malignant sarcoma of femur: What were the oncological & functional outcomes?

Abstract

Background

Currently, there is limited literature available on hip disarticulation for primary malignant bone tumours. The purpose of this retrospective study is to evaluate the demographic distribution, clinical behaviour, and oncological outcomes and functional outcomes following hip disarticulation in patients with lower extremity sarcoma.

Aims and objectives

The current study's aims and objectives were to examine clinical behaviour, oncological outcome, prognostic variables, and quality of life in patients who underwent hip disarticulation for primary sarcoma of the femur.

Material & methods

This study includes a retrospective examination of patients with primary femoral sarcoma who had hip articulation between May 2015 and December 2018. Neoadjuvant chemotherapy was administered to all patients with osteosarcoma and Ewing's sarcoma per institutional policy. The R0 resection had been performed on each patient. There were 24 patients with primary femur sarcoma (16 men and 8 women). The patients' median age was 28.5 years (range 11 years–70 years).

Results

Among 24 patients, 5 patients had distant metastasis at presentation. The computed median overall survival was 23.1 months (95 % CI:(14.76, 31.44)). Osteosarcoma, Ewing's sarcoma, and chondrosarcoma were the three most frequent cancers associated with hip disarticulation. During follow-up, thirteen patients (68.4 %) out of 19 patients suffered a recurrence. Disease-free survival was 16.97 months(95 % CI:(1.89, 32.04)). Metastatic disease at presentation was associated with a low overall survival rate. Both overall survival and disease-free survival were found to have strong positive correlation with pathological fracture at presentation. Quality of Life assessment of live patients shows reasonable ECOG and general health to maintain personal care.

Conclusion

Hip disarticulation is a surgical option reserved for individuals with non-salvageable tumours around the knee and hip joint. Hip disarticulation is associated with a poor prognosis, a high recurrence rate, and a low long-term survival rate. To employ emerging technology to enhance the quality of life and prosthetic limb, more research and study must be done.