Complications and outcome of external hemipelvectomy in the management of pelvic tumors

• Published in: Annals of surgical oncology Vol. 3; no. 3; pp. 304 - 309
• Main Authors: Apffelstaedt, J P, Driscoll, D L, Spellman, J E, Velez, A F, Gibbs, J F, Karakousis, C P
• Format: Journal Article
• Language: English
• Published: United States 01.05.1996
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Female; Hemipelvectomy - adverse effects; Hemipelvectomy - methods; Humans; Male; Middle Aged; Pelvic Neoplasms - mortality; Pelvic Neoplasms - surgery; Postoperative Complications - etiology; Prognosis; Retrospective Studies; Survival Rate
• ISSN: 1068-9265; 1534-4681
• DOI: 10.1007/bf02306287

Although the technique of external hemipelvectomy has been adequately described, little is known about its complications and late results. Retrospective review of 68 external hemipelvectomies performed at our Institute between 1973 and 1994. Eleven patients had bone tumor; 39 patients, soft-tissue sarcoma; seven patients, melanoma; 10 patients, squamous cell carcinoma; and one patient, giant neurofibroma. In 48 (71%) patients, the intent was curative. In 17 cases, the hemipelvectomy was extended. Postoperative complications occurred in 36 (53%) patients, including flap necrosis in 11 (16%), wound infection in 24 (35%), and other complications in 12 (18%). Four (6%) patients died postoperatively. The average hospital stay after curative versus palliative resection was 39 versus 24 days. Only three (5%) patients were able to use a prosthesis, whereas 55 (81%) used crutches, six (9%) remained wheelchair bound, and four patients (6%) spent most of the time in bed. Local recurrence occurred in 35% of the patients. The estimated 5-year survival for curatively resected patients was 21%. External hemipelvectomy is a procedure with considerable morbidity and is indicated for only a minority of far-advanced tumors. It offers a chance of palliation and possibly cure when lesser surgical options have been exhausted.