[Surgical therapy of metastases of the pelvis and sacrum]

We are reporting on 42 surgical and 5 conservative treatment approaches in metastases of the pelvis and sacrum. With an average disease-free survival of 14.4 months the majority of the lesions were resected intralesionally. In the area of the ischium and the pubis resection alone was done without further stabilizing measures. If the resection was in the area of the iliac wings, stabilization was achieved by means of osteosynthesis in 50% of the cases. Periacetabular resections required reconstruction with endoprotheses in all cases. In patients with good prognosis and solitary metastases also extralesional resections were performed. Reoperated embolization was used in advanced stages of the disease or if the metastases were not easily accessible surgically. Because of the complexity of pelvic resections and the often considerable loss of function, patients with metastases are often treated with intralesional resection and osteosynthesis. In exceptional cases, if radiotherapy had failed or multiple intralesional resections were followed by recurrences, we feel however that extralesional resection should be attempted with good prognosis for the patient.