Patient survival after surgical resection of pelvic bone sarcomas: A nationwide cohort study

Background: Pelvic bone sarcomas are extremely rare malignant tumours. Patients require a multidisciplinary approach to plan the treatment and complex surgical resections and limb-sparing reconstructions associated with complications, revisions, and functional limitations. The presented nationwide study in the Republic of Slovenia aims to analyse the oncological survival and functional outcomes of patients after primary resection of pelvic bone sarcomas. Methods: The retrospective observational cohort included 21 consecutive patients who underwent limb-sparing pelvic resection at a specialized orthopaedic oncology centre in the Republic of Slovenia between 2004-2022. Patient survival, complication rates, and functional outcomes were analysed according to to the primary diagnosis. Results: Wide margins with R0 resection were achieved in 16 (76%) cases. After a median follow-up of 5.7 (0.6-18.1) years, 7 (33%) patients died of oncological disease, 3 (14%) patients were alive with oncological disease, and 11 (53%) patients were alive with no evidence of disease. The estimated Kaplan-Meier survival probability at 2 years, 5 years, and 10 years after pelvic resection was 85%, 73%, and 45%, respectively. The major complication rate was 29%. The mean Musculoskeletal Tumour Society Score was 17.5 (range 2-29). Conclusions: Patient survival after resection of pelvic bone sarcomas in Slovenia between 2004-2022 is comparable to previously published reports of European and North American countries. Wide resection of tumours with reconstruction provides a relatively good survival rate, although complications are common and functional outcomes are often poor.