The surgical therapy of periacetabular malignant tumors

Objective To study the limb salvage methods and treatment outcomes in malignant periacetabular bone tumors.Methods The data of 31 patients of periacetabular malignant tumors who had limb salvage surgery between January 1999 and December 2006 was retrospectively reviewed.There were 14 females and 17 males with a mean age of 53 years (range,42-75 years).Twenty-four patients had chondrosarcomas,4 patients had Ewing sarcomas,1 patient had osteosarcoma,and the remaining 2 patients had metastatic disease.Sixteen patients had Types Ⅱ pelvic resections.5 patients had Types Ⅰ and Ⅱ pelvic resections,another 5 had Type Ⅱ and Ⅲ pelvic resections,and Type Ⅰ,Ⅱ and Ⅲ pelvic resections in the remaining patients.Seventeen patients had reconstructions after tumor resection.Results The mean follow-up time for all patients was 52 months(range,12-84 months).Fourteen patients were alive with no evidence of disease,4 patients were alive with disease at the most recent follow-up,and 13 patients died of disease.The local recurrence rate and mortality rate in 24 patients with chondrosarcomas was 20.8% and 33.3% respectively.Two patients with metastatic disease died at 11 and 34 months postoperatively.One patient with osteosarcoma and 2 patients with Ewing Sarcoma died of lung metastases.Enneking scoring system was used to evalume the functional outcome in 18 alive patients. In 13 patients who had reconstructions,6 were in excellent,6 were in good,and 1 was in poor.While in 6 patients who had no reconstructions,3 were in excellent,2 were in good,and 1 was in poor.Minor complications Occurred in 6 patients.Conclusions Clear margin tumor resection with decreased local recurrence rate is critical for limb salvage surgery in periacetabular sarcomas.The ranges of tumor invasion and resection,the principle of individual treatment should be considered in functional reconstruction. Key words: Pelvis; Bone neoplasms; Limb salvage; Reconstruction