Clinical outcomes following surgical resection of primary malignant pelvic bone tumours: an 18-year single-centre series

Pelvic resections for primary malignant bone tumours are technically demanding procedures associated with a high risk of complications. The aim of this study was to present the 18-year experience of a single referral centre in the surgical treatment of primary malignant pelvic bone tumours by analysing patient characteristics, oncological outcomes, surgical outcomes, functional outcomes, postoperative complications and survival. We retrospectively analysed 50 adult patients who underwent initial, curative-intent pelvic resection for non-metastatic primary malignant bone tumours at a single institution between 2006 and 2023. The minimum follow-up was 24 months (mean 82.3 months), except for patients who died earlier during follow-up. Survival was analysed using Kaplan-Meier estimates. Chondrosarcoma was the most common histological diagnosis (54%). Reconstruction was performed in 21 patients (42%), predominantly after periacetabular resections ( p < 0.001; Cramér’s V = 0.758). Mean operative time was 325 min and was significantly longer in reconstructed cases (444 vs. 238 min; Welch’s t-test, p < 0.001). Among 49 evaluable patients, 83.7% remained ambulatory at the latest follow-up. Local recurrence occurred in 11 patients (22%) and infection in 15 patients (30%). Non-radical resections (R1/R2) were strongly associated with local recurrence (61.5% vs. 8.1%; p < 0.001; Cramér’s V = 0.566) and significantly worse overall survival (log-rank test: χ² = 14.33; p < 0.001). Pelvic resections for primary malignant bone tumours carry a high risk of complications. Achieving R0 resection remains strongly associated with improved local control and survival. Not applicable.