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[Pelvic reconstructions after bone tumor resection].

Philippe Anract1, David Biau1, Antoine Babinet1

  • 1Service de chirurgie orthopédique et oncologique, Hôpital Cochin, AP-HP Université Paris-Descartes, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France.

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Summary
This summary is machine-generated.

Primitive malignant bone tumors of the iliac bone, including chondrosarcoma, Ewing sarcoma, and osteosarcoma, require wide resection. Reconstruction is crucial for acetabular resections, with outcomes varying based on surgical extent.

Keywords:
bone tumorchondrosarcomailiac boneosteosarcomasarcomasurgical resection

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Area of Science:

  • Orthopedic Oncology
  • Surgical Oncology
  • Bone Tumors

Context:

  • The iliac bone is a rare site for primitive malignant bone tumors, with chondrosarcoma, Ewing sarcoma, and osteosarcoma being most frequent.
  • Treatment involves wide resection, often combined with chemotherapy for Ewing sarcoma and osteosarcoma.
  • Reconstruction is necessary for acetabular and pelvic ring resections to achieve functional outcomes.

Purpose:

  • To review treatment strategies and outcomes for malignant bone tumors of the iliac bone.
  • To evaluate the challenges and results of acetabular reconstruction following tumor resection.
  • To compare functional and oncological results based on the extent of iliac bone resection.

Summary:

  • Wide resection is the primary treatment for iliac bone malignant tumors.
  • Iliac wing resections without pelvic ring disruption do not require reconstruction.
  • Acetabular resections, especially with pelvic ring disruption, necessitate complex reconstruction, with varied functional results.
  • Various reconstruction methods exist, including autografts, allografts, and prostheses.
  • Oncological outcomes are generally poorer than for distal limb tumors, with local recurrence rates between 17-45%.

Impact:

  • Acetabular reconstruction remains a technically demanding challenge with uncertain functional results.
  • Functional outcomes are good after iliac wing and obturator ring resections.
  • Poorer functional results are observed after hemipelvic or acetabular and iliac wing resection-reconstruction, particularly with gluteal muscle resection.
  • Favorable results are associated with isolated acetabular or acetabular plus obturator ring resections.