Resection margins obtained with patient-specific instruments for resecting primary pelvic bone sarcomas: A...

Area of Science:

• Orthopedic Oncology
• Surgical Oncology
• Medical Device Technology

Background:

• Limb salvage surgery for pelvic bone sarcoma has a high risk of local recurrence.
• Patient-specific instruments (PSIs) show potential for achieving tumor-free resection margins.
• Medium-term outcomes of PSI-guided resections for pelvic sarcomas are not well-documented.

Purpose of the Study:

• To evaluate if PSI-guided resection reduces local recurrence rates in pelvic bone sarcoma.
• To determine if PSI-guided resection shortens operative time.
• To assess the quality of allograft reconstruction following PSI-guided resection.

Main Methods:

• A case-control study comparing 9 patients undergoing PSI-guided resection with 19 historical controls.
• Analysis of local recurrence rates, operative times, and resection margin status (R0, R1, R2).
• Assessment of allograft reconstruction quality in patients who received them.

Main Results:

• No local recurrences were observed in the PSI-guided group (0/9) versus 7/19 in the control group (p=0.03) after a mean follow-up of 52 months.
• Bone resection margins were R0 in 8/9 PSI-guided cases, compared to R0 in 13/19 controls (p=0.47).
• Mean operative times were similar between groups (612 min for PSI vs. 633 min for controls, p=0.87).

Conclusions:

• PSI-guided resection is associated with a significantly lower local recurrence rate in primary pelvic bone sarcomas.
• PSIs improve resection accuracy, leading to a higher rate of R0 bone margins.
• PSI-guided surgery is effective for achieving tumor-free margins and satisfactory allograft reconstruction in complex pelvic sarcoma cases.