Evaluation of the efficacy of pelvic malignant bone tumor resection and function reconstruction

Abstract

Objective To discuss the efficacy of pelvic region Ⅰ-Ⅲ malignant bone tumor resection and function reconstruction. Methods A retrospective study was performed on 23 patients with pelvic malignant bone tumors who underwent limb salvage surgery in the Second Hospital of Shanxi Medical University from January 2010 to December 2018, including 12 males and 11 females, aged 19-78 years old. There were 22 cases of primary tumors, and 1 case of metastatic carcinoma. The tumor of 13 cases located in region Ⅰ, 2 cases in region Ⅱ, 5 cases in region Ⅲ, 1 case in region Ⅱ+Ⅲ, and 2 cases in region Ⅰ+Ⅱ. The surgical methods included resection + allograft, resection + pedicle screw reconstruction, resection + ipsilateral iliac bone graft reconstruction, and artificial hemipelvic replacement. The complications, outcomes, survival, and function recovery of patients were analyzed. Results None of the 23 patients died in the perioperative period. Five patients with tumor invasion region Ⅱ underwent hemipelvic replacement, and no serious complications occurred after operation; 15 patients underwent allogeneic bone graft or autologous bone graft after tumor resection, 2 of them had milder wound infection, and no serious complications were found in the others; 3 cases underwent pedicle screw reconstruction after tumor resection, and no obvious complications occurred after operation. By the end of follow-up, 12 patients died of local recurrence or lung metastases after surgery, including 4 patients who underwent hemipelvic replacement. The gait of 23 patients was changed to some extent, most of them were claudication; One patient needed to walk with two crutches. Conclusions The malignant bone tumors in the pelvic region Ⅰ and Ⅲ can achieve satisfactory postoperative results after extensive resection in the boundary of security. For pelvic region Ⅱ malignant bone tumors, the postoperative curative effect of half pelvic prosthesis reconstruction after resection in the boundary of security is acceptable. Key words: Bone neoplasms; Pelvis; Bone remodeling; Limb salvage surgery