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骨盆肿瘤切除术后模块化半骨盆假体重建:50例连续病例报告

Reconstruction with modular hemipelvic endoprosthesis after pelvic tumor resection: a report of 50 consecutive cases.

作者信息

Wang Bo, Xie Xianbiao, Yin Junqiang, Zou Changye, Wang Jin, Huang Gang, Wang Yongqian, Shen Jingnan

机构信息

Department of Musculoskeletal Oncology, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.

出版信息

PLoS One. 2015 May 26;10(5):e0127263. doi: 10.1371/journal.pone.0127263. eCollection 2015.

Abstract

PURPOSE

To evaluate the effectiveness of reconstruction with a modular hemipelvic endoprosthesis after pelvic tumor resection.

METHODS

We retrospectively studied 50 consecutive patients diagnosed with pelvic tumor from 2003 to 2013. All patients received limb-salvage surgery and reconstruction with modular hemipelvic endoprosthesis.

RESULTS

Patients were followed for an average of 54 months. At the most recent follow-up, 32 patients were alive with an estimated three-year and five-year survival rate of 66.3% and 57.5% according to the Kaplan-Meier survival analysis. Eighteen patients died from the tumor, with a mean survival of 28 months, and 9 patients experienced local recurrence at an average of 19.6 months after surgery. Patients with marginal or intracapsular surgical margins had a significantly higher recurrence rate than those with wide margins (p=0.02). Metastasis occurred in 12 cases at an average of 16 months after surgery. The perioperative complication rate was 48.0%, and the most common complications were wound healing disturbance (28.0%) and deep infection (14.0%). The endoprosthetic complication rate was 16.0%, and breakage of the pubic connection plate was the most common complication. The mean Musculoskeletal Tumor Society score was 61.4%.

CONCLUSION

Reconstruction with a modular hemipelvic endoprosthesis after pelvic tumor resection can improve function, with an acceptable complication rate.

摘要

目的

评估骨盆肿瘤切除术后采用模块化半骨盆假体进行重建的有效性。

方法

我们回顾性研究了2003年至2013年连续诊断为骨盆肿瘤的50例患者。所有患者均接受了保肢手术并采用模块化半骨盆假体进行重建。

结果

患者平均随访54个月。在最近一次随访时,根据Kaplan-Meier生存分析,32例患者存活,估计三年和五年生存率分别为66.3%和57.5%。18例患者死于肿瘤,平均生存期为28个月,9例患者出现局部复发,平均在术后19.6个月。手术切缘为边缘性或囊内性的患者复发率显著高于切缘为广泛性的患者(p = 0.02)。12例发生转移,平均在术后16个月。围手术期并发症发生率为48.0%,最常见的并发症是伤口愈合障碍(28.0%)和深部感染(14.0%)。假体并发症发生率为16.0%,耻骨连接板断裂是最常见的并发症。肌肉骨骼肿瘤学会平均评分为61.4%。

结论

骨盆肿瘤切除术后采用模块化半骨盆假体进行重建可改善功能,并发症发生率可接受。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5024/4444202/9271ee70f2be/pone.0127263.g001.jpg

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