Treatment and Results of Malignant Tumors Arising in the Pelvic Region

Maligant pelvic tumors are difficult to manage because of a high incidence of recurrence and systemic spread. The long latency period between onset and diagnosis greatly increases the probability of metastasis. Patients are thus inevitably operated on after a considerable delay. Between 1975 and 1995, 33 patients had primary malignant tumors involving the pelvis. The ages of the patients (18 men and 15 women) ranged from 12 to 17 years, with an average of 41.8. Follow-up ranged form 7 months to 12 years, with an average of 28 months. There were 15 lesions in the ilium, eight in the ischio-pubic region, three in the sacrum, and seven soft tissue lesions invading pelvis. Of the 33 patients, 12 underwent wide resection including 7 hemipelvectomies, 7 marginal resections, and 6 patients an intralesional resection. In twelve patients, local recurrences had occurred. The main cause of local reccurrences was an inadequate surgical margin. In a patient aged 18 with malignant fibrous histiocytoma, after two courses of successful chemotherapy (VAC and MAID) and irradiation (30Gy of Liniac), a modified hemipelvectomy was intended. No further chemotherapy could be performed because of post-operative deep seated infection. The cause of the infection was thought to be radiation induced erosive dermatitis. The patient had distant metastases in the retroperitoneal cavity and left ilium 4 months after surgery.