Surgical Treatment of Primary Malignant Pelvic Tumors

Purpose: To analyze the functional and oncologic outcomes and the possible complications involved in the surgical treatment of primary malignant pelvic tumors. Materials and Methods: 21 patients (10 males, 11 females) with pelvic tumors who received surgical treatment from December 1994 to May 2004 were studied retrospectively. The mean age was 39.1 years (ranging from 5 to 69 years) and the mean follow-up period was 27.9 months (ranging from 10 to 68 months). Pathologic diagnoses included 10 cases of chondrosarcoma, 6 cases of osteosarcoma, 2 cases each of myeloma and Ewing's sarcoma, and 1 case of liposarcoma. The pelvic lesions were located in 3 places; there were 10 cases in the ilium, 4 in the acetabulum, and 7 in the ischium. Seven patients had wide excision only, 9 had wide excision with intraoperative radiated bone graft (IORBG), 3 had wide excision with Pasteurization, and 2 patients had wide excision with prosthesis. We evaluated functional outcomes as described by the Musculoskeletal Tumor Society (MSTS) score (1993) and investigated complications and oncologic results. Results: The Average MSTS score was 72.3% (4 cases of osteosarcoma, 2 cases of chondrosarcoma, 1 case each of myeloma and liposarcoma were excluded due to mortality). The MSTS score of the ilium lesion was 76.2%, the acetabulum 61.7%, and the ischium 70.0%. The MSTS score of the chondrosarcoma was 72.5%, the osteosarcoma 75.0%, the myeloma 73.3%, and Ewing's sarcoma 68.3%. As evaluated by onlcologic results, 11 patients were NED (alive with no evidence of disease), 2 were AWD (alive with disease), 2 were DOC (died of other causes), and 6 were DOD (died of disease). Complications occurred in 6 cases; 3 cases of local recurrence, 2 cases of deep infection and 1 case of skin defects. Conclusion: Surgical treatment of a pelvic tumor is an effective optional management for better functional and oncologic results in spite of the technical difficulties and considerable complications.