Surgical treatment of pelvic chondrosarcoma

Objective To assess the resection,reconstruction,complication and treatment outcomes of the pelvic chondrosarcoma.Methods The data of 21 patients of pelvic chondrosarcoma were retrospectively reviewed.There were 12 females and 9 males with the median age of 46 years(range,16~65 years).According to Enneking pelvic classification system,2 patients were classified as type Ⅰ,5 as type Ⅰ and Ⅱ,6 as type Ⅱ,7 as type Ⅱ and Ⅲ,1 as type Ⅲ.The pathological details were:12 cases of well-differentiated chondrosarcoma,differentiated chondrosarcoma in 5 cases,2 cases of poorly differentiated chondrosarcoma,mesenchymal chondrosarcoma in 2 patients.Allograft was used in 2 patients after inactivation of tumor curettage.One patient underwent skeletal reconstruction of rod-screw system and allograft was used for pelvic repair in 1 patient after iliac local resection.One patient used autograft and internal fixation for reconstruction after pubis resection.Two patients underwent hemipelvectomy and 5 patients underwent internal hemipelvectomy.Acetabular reconstructions were performed in 9 cases.Results The average duration of follow-up was 39 months(range,7-100 months).Seventeen cases survived freely,2 survived with tumor,and 2 died.Local recurrence was observed in 5 of the 16 cases treated with widely excision,and it was also observed in 3 of the 5 cases treated with intralesional excision and marginal excision.The local recurrence rate and mortality rate in 21 patients with chondrosarcomas were 38.1% and 9.5%,respectively.The average ISOLS function score for the 19 patients was 19(range,7~25).The controllable complications occurred in 8 cases.Conclusions The best method for the pelvic chondrosarcoma treatment is wide excision.Prevention and active treatment of complications is the key to success of surgical treatment.