EXTERNAL AND INTERNAL HEMIPELVECTOMY FOR SARCOMAS OF THE PELVIC GIRDLE - CONSEQUENCES OF LIMB-SALVAGE TREATMENT

The outcome of different Limb-saving treatment modalities for pelvic g irdle sarcoma is controversial. The oncological and functional results after 11 external and 10 internal hemipelvectomies and the consequenc es of limb-salvage treatment were studied in 21 consecutive patients w ith primary bone (19 patients) or soft tissue sarcoma (two patients) o f the pelvic girdle, Following external hemipelvectomy 10 patients (91 %) died after a median follow-up of 1.6 years (range: 0.3-7.1). Isolat ed local recurrences occurred in three patients (27%), with concomitan t distant failure in one (9%), while isolated distant failure occurred in sis patients (55%), The rate of flap necrosis and wound infection following external hemipelvectomy were both 25%. Following internal he mipelvectomy, nine patients (90%) were alive without evidence of disea se after a median follow-up of 6.6 years (range: 2.3-16.0), Concomitan t local and distant failures were found in one patient (10%), Reconstr uction-related complications necessitated revisional procedures in fiv e of seven patients (72%), leading to external hemipelvectomy in one, Patients with a focally advanced pelvic girdle sarcoma who ape unable to under an internal hemipelvectomy a worse prognosis than patients wh o undergo an internal hemipelvectomy. An internal hemipelvectomy is no t attended by an increased risk of local failure, but is by long-term local complications requiring extensive surgical procedures.