External Hemipelvectomy in Soft Tissue Sarcomas: Are They Still Needed?

Area of Science:

• Oncology
• Surgical Oncology
• Reconstructive Surgery

Background:

• External hemipelvectomy is a radical procedure often perceived as obsolete due to technological advancements and high complication rates.
• High-grade ulcerated soft tissue sarcomas present unique challenges in the gluteal region.

Purpose of the Study:

• To review the current literature on external hemipelvectomy for soft tissue sarcomas.
• To present two distinct cases of gluteal soft tissue sarcomas treated with extended external hemipelvectomy.

Main Methods:

• A literature review of PubMed (2014-2024) was conducted.
• Two cases of high-grade soft tissue sarcomas in young and elderly female patients were analyzed.
• Treatment involved extended external hemipelvectomy, with one case including abdominoperineal amputation and colostomy.

Main Results:

• Case 1: A young female patient achieved a good outcome with a normal life, including a successful pregnancy and delivery.
• Case 2: An elderly female patient experienced complications including intestinal perforation and sepsis, leading to mortality 2.5 months post-surgery.

Conclusions:

• External hemipelvectomy is a viable, albeit demanding, surgical option for selected soft tissue sarcoma cases.
• Individualized treatment approaches, multidisciplinary committee review, and informed patient consent are crucial for successful outcomes.
• The principles of individualized treatment may be applicable to other complex pathologies.