COMPLICATIONS AND OUTCOME OF EXTERNAL HEMIPELVECTOMY IN THE MANAGEMENT OF PELVIC TUMORS

Background: Although the technique of external hemipelvectomy has been adequately described, little is known about its complications and lat e results. Design: Retrospective review of 68 external hemipelvectomie s performed at our Institute between 1973 and 1994. Materials and meth ods: Eleven patients had bone tumor; 39 patients, soft-tissue sarcoma; seven patients, melanoma; 10 patients, squamous cell carcinoma; and o ne patient, giant neurofibroma. In 48 (71%) patients, the intent was c urative. In 17 cases, the hemipelvectomy was extended. Results: Postop erative complications occurred in 36 (53%) patients, including flap ne crosis in 11 (16%), wound infection in 24 (35%), and other complicatio ns in 12 (18%). Four (6%) patients died postoperatively. The average h ospital stay after curative versus palliative resection was 39 versus 24 days, Only three (5%) patients were able to use a prosthesis, where as 55 (81%) used crutches, six (9%) remained wheelchair bound, and fou r patients (6%) spent most of the time in bed. Local recurrence occurr ed in 35% of the patients. The estimated 5-year survival for curativel y resected patients was 21%. Conclusions: External hemipelvectomy is a procedure with considerable morbidity and is indicated for only a min ority of far-advanced tumors, It offers a chance of palliation and pos sibly cure when lesser surgical options have been exhausted.