Lehner Burkhard, Bollmann Jakob, Geisbüsch Andreas, Beckmann Nicholas Andreas
Department of Orthopaedics, Heidelberg University Hospital, 69118 Heidelberg, Germany.
German Bone Tumor Working Group, 4031 Basel, Switzerland.
Diagnostics (Basel). 2025 Jun 6;15(12):1452. doi: 10.3390/diagnostics15121452.
Internal hemipelvectomies are rare procedures for primary musculoskeletal sarcomas of the bony pelvis. There is a sparse amount of data on functional outcomes and activity levels in postoperative patients. The aim of this study was to investigate functional outcomes, including sport activity levels, and the impact of tumor grade, resection margins, adjuvant therapies, pelvic reconstruction, and patient age at the time of surgery. Patients who underwent internal hemipelvectomy at our clinic between 1995 and 2019, with a minimum follow-up of 12 months, were assessed using the Musculoskeletal Tumor Society Score (MSTS), the Toronto Extremity Salvage Score (TESS), the Oxford Hip Score (OHS), and the University of Los Angeles Activity Scale (UCLA AS). Our cross-sectional study included 29 patients (14 male, 15 female; 15 with chondrosarcoma, 8 with Ewing's sarcoma, 2 with osteosarcoma, 2 with chordoma, and 2 with other sarcomas) with a median follow-up of 8.7 years (range: 12 months to 25.4 years; interquartile range (IQR): 13.1 years). The median MSTS was 16 (range: 1-30; IQR: 9), median TESS was 75.8% (range: 12.9-100%; IQR: 31.7%), median OHS was 35 (range: 10-48; IQR: 16), and median UCLA AS was 5 (range: 1-9; IQR: 3). Tumor grade, resection margins, chemotherapy, radiation therapy, and pelvic reconstruction had no significant effect on functional outcomes. Patient age at the time of surgery had a statistically significant effect on all measured outcome parameters, although all parameters exhibited a wide range and large IQR, likely reflecting the small, heterogeneous patient cohort. Surviving patients who underwent internal hemipelvectomy for primary musculoskeletal sarcomas of the pelvic bone demonstrated overall moderate to good functional outcomes and moderate sport activity levels.
半骨盆内切除术是治疗骨盆原发性肌肉骨骼肉瘤的罕见手术。关于术后患者功能结局和活动水平的数据稀少。本研究的目的是调查功能结局，包括运动活动水平，以及肿瘤分级、切除边缘、辅助治疗、骨盆重建和手术时患者年龄的影响。对1995年至2019年期间在我们诊所接受半骨盆内切除术且随访至少12个月的患者，使用肌肉骨骼肿瘤学会评分（MSTS）、多伦多肢体挽救评分（TESS）、牛津髋关节评分（OHS）和洛杉矶大学活动量表（UCLA AS）进行评估。我们的横断面研究包括29例患者（14例男性，15例女性；15例软骨肉瘤，8例尤因肉瘤，2例骨肉瘤，2例脊索瘤，2例其他肉瘤），中位随访时间为8.7年（范围：12个月至25.4年；四分位间距（IQR）：13.1年）。MSTS中位数为16（范围：1 - 30；IQR：9），TESS中位数为75.8%（范围：12.9 - 100%；IQR：31.7%），OHS中位数为35（范围：10 - 48；IQR：16），UCLA AS中位数为5（范围：1 - 9；IQR：3）。肿瘤分级、切除边缘、化疗、放疗和骨盆重建对功能结局无显著影响。手术时患者年龄对所有测量的结局参数有统计学显著影响，尽管所有参数都呈现出较宽的范围和较大的IQR，这可能反映了患者队列规模小且异质性大。接受半骨盆内切除术治疗骨盆原发性肌肉骨骼肉瘤的存活患者总体功能结局为中度至良好，运动活动水平为中度。
