Department of Orthopaedic Surgery and Traumatology, Marmara University School of Medicine, Istanbul, Turkey.
J Surg Oncol. 2021 Feb;123(2):532-543. doi: 10.1002/jso.26318. Epub 2020 Nov 25.
This study aimed to analyze the midterm outcomes of LUMiC® endoprosthetic reconstruction following periacetabular resection of primary bone sarcomas and carcinoma metastases.
We retrospectively reviewed the charts of 21 patients (11 male [52.3%], 10 female [47.6%]; mean age 47 ± 16 years) for whom a LUMiC® endoprosthesis (Implantcast) was used to reconstruct a periacetabular defect after internal hemipelvectomy. The tumor was pathologically diagnosed as Ewing's sarcoma in six (28.5%), chondrosarcoma in 10 (47.6%), and bone metastasis from carcinoma in five (23.8%) patients.
The median follow-up of patients was 57.8 months (95% confidence interval: 51.9-63.7). The implant survival rate at 1, 2, and 5 years were 95.2%, 85.7%, and 80.9%, respectively. The overall complication rate was 33.3% (n = 7). Four (19%) complications resulted in reconstruction failure. Total reoperation rate was 28.5% (n = 6). The complications were soft tissue failure/dislocation in two patients, aseptic loosening in one, infection in two, and local recurrence in two. At the time of study, seven patients were alive with no evidence of disease, seven were alive with disease, and seven died of disease. The 5-year overall survival rate and local recurrence-free survival rates were 67% and 76%, respectively. The median Musculoskeletal Tumor Society score at final follow-up was 70% (range: 50%-86.6%).
We conclude that LUMiC® endoprosthesis provides good functional outcomes and a durable reconstruct. Even though this reconstruction method presents some complications, it provides a stable pelvis in the management of periacetabular malignant tumors.
本研究旨在分析原发性骨肉瘤和癌转移患者行髋臼周围切除术后采用 LUMiC®内置假体重建的中期结果。
我们回顾性分析了 21 例患者（男 11 例[52.3%]，女 10 例[47.6%]；平均年龄 47±16 岁）的病历，这些患者在接受半骨盆切除术后采用 LUMiC®内置假体（Implantcast）重建髋臼周围缺损。肿瘤病理诊断为尤文肉瘤 6 例（28.5%）、软骨肉瘤 10 例（47.6%）和癌骨转移 5 例（23.8%）。
患者的中位随访时间为 57.8 个月（95%置信区间：51.9-63.7）。1、2、5 年的假体生存率分别为 95.2%、85.7%和 80.9%。总体并发症发生率为 33.3%（n=7）。4 例（19%）并发症导致重建失败。总再手术率为 28.5%（n=6）。并发症包括软组织失败/脱位 2 例，无菌性松动 1 例，感染 2 例，局部复发 2 例。研究时，7 例患者无瘤生存，7 例患者带瘤生存，7 例患者死于疾病。5 年总生存率和局部无复发生存率分别为 67%和 76%。末次随访时的肌肉骨骼肿瘤协会评分中位数为 70%（范围：50%-86.6%）。
我们认为 LUMiC®内置假体可提供良好的功能结果和持久的重建效果。尽管这种重建方法存在一些并发症，但它为髋臼周围恶性肿瘤的治疗提供了一个稳定的骨盆。
