[Limb salvage surgery for pelvic malignancies followed by reconstruction with hip endoprosthesis]

Between 1983 and 1987, nine patients with pelvic malignancy were treated with limb salvage surgery and preoperative chemotherapy. They were 6 males and 3 females, ranging in age from 13 to 73. There were 4 chondrosarcomas, 3 osteosarcomas and 2 Ewing's sarcomas. Seven patients received preoperative chemotherapy mainly consisting of adriamycin and cis-platinum. The remaining 2 patients with Ewing's sarcoma received T-11 protocol by Rosen. Surgical margins were wide but partially marginal in 6 patients and intra-lesional in 3 patients. Reconstruction with hip endoprosthesis fixed with screws and bone cement in the sacrum was performed after whole involved iliac bone was resected. Local recurrence was detected in one patient with osteosarcoma treated by marginal resection and 2 patients treated by intralesional resection. Complications occurred in 5 patients. Dislocation was observed in the first patient in this series. Other complications were infection in one patient, sciatic nerve palsy in one patient and leg length shortening in 2 patients. One patient walks without crutches, 5 patients with them. One patient uses a wheelchair and 2 patients are on bed rest. Four patients survived with no evidence of disease for 8-51 months (average 25 months). Two patients have survived with disease for 11-16 months (average 14 months). Three patients died from metastasis a 6-10 months (average 9 months).