[Hemipelvectomy for pelvic sarcomas].
Hemipelvektomie bei Sarkomen des Beckens.
Amputation
Bone cancer
Chondrosarcoma
Limb salvage
Pelvis
Journal
Der Orthopade
ISSN: 1433-0431
Titre abrégé: Orthopade
Pays: Germany
ID NLM: 0331266
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
pubmed:
9
8
2019
medline:
27
9
2019
entrez:
9
8
2019
Statut:
ppublish
Résumé
Hemipelvectomy is an important technique for the treatment of pelvic sarcomas. Presentation of the technical overview, as well as surgical and oncological outcomes of sarcoma patients treated with pelvic tumor resections and treatment recommendations. Retrospective analysis of 160 patients treated by pelvic tumor resection for chondrosarcoma between 1977 and 2014. Chondrosarcoma was the most common diagnosis leading to pelvic tumor resection in this collective (38%). The mean patient age at operation was 49 years. 44 patients were treated for G1, 83 patients for G2 and 33 patients for G3 or dedifferentiated chondrosarcoma. The mean tumor diameter was ≥10 cm in 76.1% of cases. Limb salvaging operations were possible in 82.5% of patients. The most common reconstruction technique was hip transposition (38.7%). Clear resection margins were achieved in 86.9% (R0). Local recurrence was observed in 22.5%. Distant pulmonal metastasis was diagnosed in 25% of patients. Grading-specific survival was 81.8% for G1, 59% for G2 and 24.2% for G3 or dedifferentiated chondrosarcoma with a mean survival of 84.4, 89 and 69.4 months respectively. Pelvic tumor resection with clear margins is the most important known positive predictive local factor affecting overall outcomes, in addition to uncontrollable factors such as grading and tumor size. Defect reconstruction depends on multiple factors such as patient age and adjuvant therapy. The stage of the disease has the greatest impact on overall survival rates and should be considered when contemplating pelvic tumor resections in sarcoma patients.
Sections du résumé
BACKGROUND
BACKGROUND
Hemipelvectomy is an important technique for the treatment of pelvic sarcomas.
OBJECTIVES
OBJECTIVE
Presentation of the technical overview, as well as surgical and oncological outcomes of sarcoma patients treated with pelvic tumor resections and treatment recommendations.
METHODS
METHODS
Retrospective analysis of 160 patients treated by pelvic tumor resection for chondrosarcoma between 1977 and 2014.
RESULTS
RESULTS
Chondrosarcoma was the most common diagnosis leading to pelvic tumor resection in this collective (38%). The mean patient age at operation was 49 years. 44 patients were treated for G1, 83 patients for G2 and 33 patients for G3 or dedifferentiated chondrosarcoma. The mean tumor diameter was ≥10 cm in 76.1% of cases. Limb salvaging operations were possible in 82.5% of patients. The most common reconstruction technique was hip transposition (38.7%). Clear resection margins were achieved in 86.9% (R0). Local recurrence was observed in 22.5%. Distant pulmonal metastasis was diagnosed in 25% of patients. Grading-specific survival was 81.8% for G1, 59% for G2 and 24.2% for G3 or dedifferentiated chondrosarcoma with a mean survival of 84.4, 89 and 69.4 months respectively.
CONCLUSIONS
CONCLUSIONS
Pelvic tumor resection with clear margins is the most important known positive predictive local factor affecting overall outcomes, in addition to uncontrollable factors such as grading and tumor size. Defect reconstruction depends on multiple factors such as patient age and adjuvant therapy. The stage of the disease has the greatest impact on overall survival rates and should be considered when contemplating pelvic tumor resections in sarcoma patients.
Identifiants
pubmed: 31392386
doi: 10.1007/s00132-019-03789-4
pii: 10.1007/s00132-019-03789-4
doi:
Types de publication
Journal Article
Review
Langues
ger
Sous-ensembles de citation
IM
Pagination
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