The Surgical Therapy Of Pelvic Chondrosarcoma

ObjectiveTo discuss the resection,reconstruction,complication and prognosis of the pelvic chondrosarcoma.MethodsThe data of 21 patients of pelvic chondrosarcoma who had operation between January 2000 and June 2009 was retrospectively reviewed.There were 12 males and 9 males with a mean age of 44.2 years(range,16-65years). According to Enneking pelvic classification system,2 patients had been classified as typeâ… ,5 had typeâ… andâ…¡,6 had typeâ…¡,7 had type II andâ…¢,1 had type III.The pathological details were:12 cases of well-differentiated chondrosarcoma, differentiated chondrosarcoma in 5 cases,2 cases of poorly differentiated chondrosarcoma,mesenchymal chondrosarcoma in 2 patients.Allograft was used in 2 patients after inactivation of tumor curettage.One patient underwent skeletal reconstruction of rod-screw system and allograft was used for pelvic repair in 1 patient after iliac local resection.One patient used autograft and internal fixation for reconstruction after pubis resection.Two patients underwent hemipelvectomy and 5 patients underwent internal hemipelvectomy.Acetabular reconstructions were performed in 9 cases.ResultsThe average duration of follow-up was 39 months (range,7-100 months).17 cases was free survival,2 survivaled with tumor, and 2 died. Local recurrences was observed in 5 of the 16 cases treated with widely excision, and it was also observed in 3 of the 5 cases treated with intralesional excision and marginal excision. The local recurrence rate and mortality rate in 21 patients with chondrosarcomas was 38.1% and 9.5% respectively. Overall the free survival rate of 3 years was 66.4%, and the free survival rate of 5 years was 53.8%. The average ISOLS function score for the 19 patients was 19(range,7-25).The controllable complications occurred in 8 cases.ConclusionEarly diagnosis of pelvic chondrosarcoma is very difficult. The modality for resection is very important to prognosis.The best method for the treatment of pelvic chondrosarcoma is wide excision. Prevention and active treatment of complications is the key to success of surgical treatment of the pelvic chondrosarcoma.