Improving oncological outcomes for pelvic bone sarcomas: Is it possible?

Area of Science:

• Orthopedic Oncology
• Surgical Oncology
• Cancer Research

Background:

• Pelvic bone sarcomas are rare and challenging malignancies.
• The impact of recent technological advancements on outcomes for diverse pelvic bone sarcoma histiotypes is not well-defined.

Purpose of the Study:

• To evaluate the effect of modern surgical techniques and navigation technologies on outcomes for primary pelvic bone sarcomas.
• To compare outcomes between historical and modern treatment cohorts.

Main Methods:

• Retrospective cohort study of 475 patients with primary pelvic bone sarcomas (2003-2022).
• Stratification into historical (2003-2012) and modern (2013-2022) cohorts.
• Assessment of disease-specific survival (DSS), local recurrence-free survival (LRFS), margin status, and technology adoption.

Main Results:

• Chondrosarcoma was the most frequent (51%), followed by Ewing sarcoma (16%) and osteosarcoma (11%).
• Increased use of navigation and patient-specific planning in the modern cohort correlated with significantly lower positive margin rates (8.5% vs. 21%).
• Improved DSS observed for chondrosarcoma and chordoma; improved LRFS for chondrosarcoma, Ewing sarcoma, and chordoma. No significant DSS improvement for osteosarcoma or Ewing sarcoma.

Conclusions:

• Centralization and technical advancements have improved local control and survival, particularly for chondrosarcoma and sacral chordoma.
• Outcomes for osteosarcoma and Ewing sarcoma remain suboptimal, indicating a need for further research and innovative strategies.