Abstract
In the surgical treatments of malignant pelvic tumors, it is often difficult to obtain an adequate surgical margin and the methods of reconstruction are still under discussion.
The surgical treatments for 13 malignant pelvic tumors (nine male and four female patients) and one giant cell tumor (male) resected in our hospital between Nov. 1987 to Aug. 1999 were investigated to evaluate the surgical results. The mean age at the time of operation was 42.3 years (17 to 80 years), and the average follow-up period was 40.5 months (5 to 132 months).
Seven of 9 patients with tumors that were resected with inadequate margin (intralesional and marginal margin) died of tumor metastasis, as did 2 of 4 patients with tumors that had wide resection. Local recurrences were recognized in 3 of the 9 patients with inadequate margin, and none with wide resection.
Reconstructions of the pelvic ring were perfomed in 4 cases of 6 cases with interruption of the pelvic ring by the tumor resection. Another 2 cases were performed internal hemipelvectomy and ilio-femoral fixation substituting the reconstruction of the pelvic ring. Two cases reconstructed with fibula graft and the case of ilio-femoral fixation showed especially good results in the postoperative functional evaluation (Enneking's functional evaluation system).
As prognosis and the frequency of local recurrence tend to be related with the method of tumor resection in our series, many efforts should be paid to obtain an adequate margin. Two patients with rigid fixation using fibula graft and ilio-femoral fixation showed good results in Enneking's functional evaluation system.
