Malignant pelvic tumors: limb-sparing resection and reconstruction

Area of Science:

• Orthopedic oncology
• Surgical reconstruction
• Pelvic tumor management

Background:

• Malignant pelvic tumors present complex surgical challenges.
• Limb salvage is a key consideration, balancing oncologic and functional outcomes.
• Pelvic stability and resection margins are critical factors in surgical planning.

Purpose of the Study:

• To evaluate the indications and outcomes of limb salvage for malignant pelvic tumors.
• To review reconstruction strategies following pelvic tumor resection.
• To identify optimal reconstructive methods based on tumor location and patient factors.

Main Methods:

• Review of limb salvage criteria, including surgical margin achievement and amputation necessity.
• Analysis of local recurrence rates in relation to resection margin status.
• Evaluation of different skeletal reconstruction techniques for pelvic defects (e.g., iliosacral arthrodesis, iliofemoral arthrodesis, prostheses).

Main Results:

• Local recurrence rates approximate 17%, higher with positive microscopic resection margins.
• Anterior pelvis or incomplete ilium resection may not require skeletal reconstruction.
• Iliosacral arthrodesis offers good function when pelvic stability is lost after ilium resection.
• Periacetabular resections present significant reconstruction challenges.
• Iliofemoral arthrodesis is favored for young, active patients due to durable, stable limb function.

Conclusions:

• Limb salvage for malignant pelvic tumors is feasible with adequate resection margins.
• Reconstruction choices depend on the extent of resection and resulting pelvic stability.
• Iliofemoral arthrodesis provides excellent functional outcomes for young, active patients undergoing periacetabular resections.