Outcome after pelvic sarcoma resection reconstructed with saddle prosthesis

Area of Science:

• Orthopedic Oncology
• Surgical Reconstruction
• Cancer Treatment Outcomes

Background:

• Pelvic sarcomas pose significant treatment challenges, often requiring extensive surgical resection.
• Saddle prostheses are utilized for pelvic reconstruction following tumor removal.
• Evaluating functional outcomes and complications is crucial for assessing treatment efficacy.

Purpose of the Study:

• To retrospectively assess the functional outcomes, survival rates, and complication profiles of patients undergoing saddle prosthetic reconstruction for pelvic sarcoma.
• To compare the functional results of saddle prosthesis reconstruction with hemipelvectomy.

Main Methods:

• Retrospective review of 27 patients with pelvic sarcoma treated with saddle prosthetic reconstruction between 1991 and 2001.
• Functional outcomes assessed using Musculoskeletal Tumor Society (MSTS) Scores (1987 and 1993) and Toronto Extremity Salvage Score (TESS).
• Survival, recurrence, metastasis, and complication rates (infection, nerve palsy, ossification, fracture, dislocation) were recorded.

Main Results:

• A 60% survival rate was observed, with 22% local recurrence and 22% metastasis.
• Mean MSTS 1993 score was 50.8%, MSTS 1987 score was 15.3%, and TESS score was 64.4%.
• Substantial morbidity included infection (37%), nerve palsies (18.5%), heterotopic ossification (37%), fracture (22%), and dislocation (22%). Limb shortening ranged from 1-6 cm.

Conclusions:

• Saddle prosthetic reconstruction for pelvic sarcoma is associated with considerable morbidity.
• Despite complications, functional results appear advantageous compared to the disability following hemipelvectomy.
• This reconstructive technique offers a viable limb-sparing option for select patients with pelvic sarcoma.