Outcomes following periacetabular tumor resection: A 25-year institutional experience.
acetabulum
allograft
bone tumor
endoprosthesis
malignancy
pelvis
reconstruction
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
04
01
2020
revised:
19
05
2020
accepted:
08
06
2020
pubmed:
1
7
2020
medline:
13
1
2021
entrez:
30
6
2020
Statut:
ppublish
Résumé
Following tumor resection involving the acetabulum (periacetabular), various methods of reconstruction exist. The objective of this study was to analyze functional outcomes and complication rates by extent of periacetabular tumor resection, as well as by method of reconstruction. Twenty-three patients underwent periacetabular resection for a primary pelvic bone tumor from 1993-2018 at a single institution. Complications were documented and functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system. Mean age was 42.8 ± 22.6 years. Mean follow-up was 107 ± 75 months. MSTS scores were highest in patients with allograft reconstruction (80.2%) and lowest in saddle reconstruction (38.0%). MSTS scores were higher in patients with Type II periacetabular resection alone compared with Type II + additional resection (78.6% vs 60.3%; P = .019). Complications were lower in patients with Type II periacetabular resection alone (75% vs 28.6%; P = .036). Complications were highest following allograft reconstruction (78%) and lowest following hemipelvectomy without reconstruction (20%). Patients who underwent allograft/APC or nonsaddle metallic reconstruction experienced the highest functional outcome scores, but also sustained a higher complication rate than patients with hemipelvectomy without reconstruction. Patients with resection of ilium and/or pubis in addition to the periacetabular region had lower functional outcome scores and higher risk for complication.
Sections du résumé
BACKGROUNDS AND OBJECTIVES
OBJECTIVE
Following tumor resection involving the acetabulum (periacetabular), various methods of reconstruction exist. The objective of this study was to analyze functional outcomes and complication rates by extent of periacetabular tumor resection, as well as by method of reconstruction.
METHODS
METHODS
Twenty-three patients underwent periacetabular resection for a primary pelvic bone tumor from 1993-2018 at a single institution. Complications were documented and functional outcomes were assessed using the Musculoskeletal Tumor Society (MSTS) scoring system.
RESULTS
RESULTS
Mean age was 42.8 ± 22.6 years. Mean follow-up was 107 ± 75 months. MSTS scores were highest in patients with allograft reconstruction (80.2%) and lowest in saddle reconstruction (38.0%). MSTS scores were higher in patients with Type II periacetabular resection alone compared with Type II + additional resection (78.6% vs 60.3%; P = .019). Complications were lower in patients with Type II periacetabular resection alone (75% vs 28.6%; P = .036). Complications were highest following allograft reconstruction (78%) and lowest following hemipelvectomy without reconstruction (20%).
CONCLUSION
CONCLUSIONS
Patients who underwent allograft/APC or nonsaddle metallic reconstruction experienced the highest functional outcome scores, but also sustained a higher complication rate than patients with hemipelvectomy without reconstruction. Patients with resection of ilium and/or pubis in addition to the periacetabular region had lower functional outcome scores and higher risk for complication.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
949-954Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Enneking WF, Dunham WK. Resection and reconstruction for primary neoplasms involving the innominate bone. J Bone Joint Surg Am. 1978;60(6):731-746.
Carmody Soni EE, Miller BJ, Scarborough MT, Parker Gibbs C. Functional outcomes and gait analysis of patients after periacetabular sarcoma resection with and without ischiofemoral arthrodesis. J Surg Oncol. 2012;106(7):844-849.
Hoffmann C, Gosheger G, Gebert C, Jürgens H, Winkelmann W. Functional results and quality of life after treatment of pelvic sarcomas involving the acetabulum. J Bone Joint Surg Am. 2006;88(3):575-582.
Windhager R, Karner J, Kutschera HP, Polterauer P, Salzer-Kuntschik M, Kotz R. Limb salvage in periacetabular sarcomas: review of 21 consecutive cases. Clin Orthop Relat Res. 1996;331:265-276.
Guest CB, Bell RS, Davis A, et al. Allograft-implant composite reconstruction following periacetabular sarcoma resection. J Arthroplasty. 1990;5(Suppl):S25-S34.
Jeon DG, Kim MS, Cho WH, Song WS, Lee SY. Reconstruction with pasteurized autograft-total hip prosthesis composite for periacetabular tumors. J Surg Oncol. 2007;96(6):493-502.
Langlais F, Lambotte JC, Thomazeau H. Long-term results of hemipelvis reconstruction with allografts. Clin Orthop Relat Res. 2001;388:178-186.
Ozaki T, Hillmann A, Bettin D, Wuisman P, Winkelmann W. High complication rates with pelvic allografts. Experience of 22 sarcoma resections. Acta Orthop Scand. 1996;67(4):333-338.
Satcher RL Jr, O'Donnell RJ, Johnston JO. Reconstruction of the pelvis after resection of tumors about the acetabulum. Clin Orthop Relat Res. 2003;409:209-217.
Yoshida Y, Osaka S, Mankin HJ. Hemipelvic allograft reconstruction after periacetabular bone tumor resection. J Orthop Sci. 2000;5(3):198-204.
Aljassir F, Beadel GP, Turcotte RE, et al. Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis. Clin Orthop Relat Res. 2005;438:36-41.
Cottias P, Jeanrot C, Vinh TS, Tomeno B, Anract P. Complications and functional evaluation of 17 saddle prostheses for resection of periacetabular tumors. J Surg Oncol. 2001;78(2):90-100.
Donati D, D'Apote G, Boschi M, Cevolani L, Benedetti MG. Clinical and functional outcomes of the saddle prosthesis. J Orthop Traumatol. 2012;13(2):79-88.
Guo W, Li D, Tang X, Ji T. Surgical treatment of pelvic chondrosarcoma involving periacetabulum. J Surg Oncol. 2010;101(2):160-165.
Jansen JA, van de Sande MA, Dijkstra PD. Poor long-term clinical results of saddle prosthesis after resection of periacetabular tumors. Clin Orthop Relat Res. 2013;471(1):324-331.
Natarajan MV, Bose JC, Mazhavan V, Rajagopal TS, Selvam K. The saddle prosthesis in periacetabular tumours. Int Orthop. 2001;25(2):107-109.
Renard AJ, Veth RP, Schreuder HW, et al. The saddle prosthesis in pelvic primary and secondary musculoskeletal tumors: functional results at several postoperative intervals. Arch Orthop Trauma Surg. 2000;120(3-4):188-194.
Guo W, Li D, Tang X, Yang Y, Ji T. Reconstruction with modular hemipelvic prostheses for periacetabular tumor. Clin Orthop Relat Res. 2007;461:180-188.
Jaiswal PK, Aston WJ, Grimer RJ, et al. Peri-acetabular resection and endoprosthetic reconstruction for tumours of the acetabulum. J Bone Joint Surg Br. 2008;90(9):1222-1227.
Ozaki T, Hoffmann C, Hillmann A, Gosheger G, Lindner N, Winkelmann W. Implantation of hemipelvic prosthesis after resection of sarcoma. Clin Orthop Relat Res. 2002;396:197-205.
Uchida A, Myoui A, Araki N, Yoshikawa H, Ueda T, Aoki Y. Prosthetic reconstruction for periacetabular malignant tumors. Clin Orthop Relat Res. 1996;326:238-245.
Zang J, Guo W, Yang Y, Xie L. Reconstruction of the hemipelvis with a modular prosthesis after resection of a primary malignant peri-acetabular tumour involving the sacroiliac joint. Bone Joint J. 2014;96-B(3):399-405.
Ham SJ, Schraffordt Koops H, Veth RP, van Horn JR, Eisma WH, Hoekstra HJ. External and internal hemipelvectomy for sarcomas of the pelvic girdle: consequences of limb-salvage treatment. Eur J Surg Oncol. 1997;23(6):540-546.
Hu YC, Huang HC, Lun DX, Wang H. Resection hip arthroplasty as a feasible surgical procedure for periacetabular tumors of the pelvis. Eur J Surg Oncol. 2012;38(8):692-699.
Penna V, Toller EA, Pinheiro CA, Becker RG. Hemipelvectomias: tratamento, avaliação funcional e prognóstica dos tumores pélvicos. Acta Ortopédica Brasileira. 2011;19:328-332.
Schwartz AJ, Kiatisevi P, Eilber FC, Eilber FR, Eckardt JJ. The Friedman-Eilber resection arthroplasty of the pelvis. Clin Orthop Relat Res. 2009;467(11):2825-2830.
Traub F, Andreou D, Niethard M, Tiedke C, Werner M, Tunn PU. Biological reconstruction following the resection of malignant bone tumors of the pelvis. Sarcoma. 2013;2013:745360.
Griesser MJ, Gillette B, Crist M, et al. Internal and external hemipelvectomy or flail hip in patients with sarcomas: quality-of-life and functional outcomes. Am J Phys Med Rehabil. 2012;91(1):24-32.
Wu S, Shi X, Zhou G, Lu M, Li C. Composite reconstruction of the hip following resection of periacetabular tumors: middle-term outcome. J Arthroplasty. 2013;28(3):537-542.
Ueda T, Kakunaga S, Takenaka S, Araki N, Yoshikawa H. Constrained total hip megaprosthesis for primary periacetabular tumors. Clin Orthop Relat Res. 2013;471(3):741-749.
Tang X, Guo W, Ji T. Reconstruction with modular hemipelvic prosthesis for the resection of solitary periacetabular metastasis. Arch Orthop Trauma Surg. 2011;131(12):1609-1615.
Henderson ER, O'Connor MI, Ruggieri P, et al. Classification of failure of limb salvage after reconstructive surgery for bone tumours: a modified system Including biological and expandable reconstructions. Bone Joint J. 2014;96-B(11):1436-1440.
Henderson ER, Groundland JS, Pala E, et al. Failure mode classification for tumor endoprostheses: retrospective review of five institutions and a literature review. J Bone Joint Surg. 2011;93(5):418-429.
Enneking WF, Dunham W, Gebhardt MC, Malawar M, Pritchard DJ. A system for the functional evaluation of reconstructive procedures after surgical treatment of tumors of the musculoskeletal system. Clin Orthop Relat Res. 1993;286:241-246.
Takami M, Ieguchi M, Takamatsu K, et al. Functional evaluation of flail hip joint after periacetabular resection of the pelvis. Osaka City Med J. 1997;43(2):173-183.
Donati D, Di Bella C, Frisoni T, Cevolani L, DeGroot H. Alloprosthetic composite is a suitable reconstruction after periacetabular tumor resection. Clin Orthop Relat Res. 2011;469(5):1450-1458.
Angelini A, Drago G, Trovarelli G, Calabrò T, Ruggieri P. Infection after surgical resection for pelvic bone tumors: an analysis of 270 patients from one institution. Clin Orthop Relat Res. 2014;472(1):349-359.
Puri A, Pruthi M, Gulia A. Outcomes after limb sparing resection in primary malignant pelvic tumors. Eur J Surg Oncol. 2014;40(1):27-33.