[Hemipelvectomy, constant surgical dilema]

Abstract

Introduction: In this report we present our experience in "post war" environment in our institution. Any king of pelvic surgery is challenging and impacts significantly on limb and visceral function. Any surgeon has to ask a question "is heroic surgery justifiable". We aim to asses functional, oncologic and surgical outcomes following pelvis tumor resections.

Materials and methods: Between 1998-2005, 7 patients (mean age 48.2 years) underwent pelvic tumor resections. All of them were primary malignant tumors. We did not identify secondary tumors and benign tumors in our series. Bone tumors were 3 osteosarcomas and 4 chondrosarcomas. Tumors involved the ilium, acetabulum, pubic bones, sacrum or a combination of these. No patient had metastases at presentation.

Results: All 7 patients underwent hindquarter amputations. Surgical margins were marginal (4), wide (2), and radical (1). There was 1 intraoperative death, 2 local recurrences and 2 metastases. Death from disease occurred at a mean of 12.4 months with mean follow-up of 24 (1-72) months. Emotional acceptance was surprisingly high. Pelvic resections are complex. Functional outcome is significantly affected by surgery. Disease control is similar to limb tumors. Emotional acceptance of surgery in survivors was surprisingly high.

Conclusion: Major pelvic resection for malignancy appears justified.