Resection of malignant bone tumors of the pelvic girdle without extremity amputation

Fifty-three patients with malignant tumors of the pelvis ossea were evaluated for location of tumor, extent of resection, postoperative function, local recurrence, and survival. Three tumors were unresectable, 17 required a wide local excision, 27 required resection of the hemipelvis without extremity amputation (internal hemipelvectomy), and six required a classical hemipelvectomy with amputation. The incidence of local recurrence was 11.8% for wide local excision, 7.4% for internal hemipelvectomy, and 33% for classical hemipelvectomy. Survival following wide local excision or internal hemipelvectomy was 58% and 41%, respectively, at five years compared with 17% for patients undergoing classical hemipelvectomy. Patients who underwent wide local excision had good to excellent functional results. Patients requiring internal hemipelvectomy initially required ambulatory supports, but many can now ambulate independently, with a neurologically intact extremity, despite a noticeably abnormal gait.