Reconstruction with Modular Hemipelvic Endoprosthesis after Pelvic Tumor Resection: A Report of 50 Consecutive Cases

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.