Page 37 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

prosthetic composites (13%), and 10 with allograft reconstructions (10%). The median duration of the surgical procedures was 4.8 hours (range, 1.5 to 10.5) (data were available for 101 patients [62%]).
Surgical margins were classi ed as wide (resection outside the reactive zone) 2 in 83 patients (51%), marginal (resection through the reactive zone, no tumor
cells at the margins) in 42 patients (26%) and intralesional (tumor cells present at
the margins) in 37 patients (23%) (table 2)26. Contaminated resections (i.e. those
resections in which tumor spill occurred) were considered to be intralesional, regardless of the margins eventually achieved. Eight patients (5%) received chemotherapy, and seven patients (4%) had adjuvant radiotherapy for inadequate margins or local recurrence. The occurrence of local recurrence was assessed on imaging (usually MRI) and on histopathology in case a further surgical procedure was performed.
Kaplan-Meier curves were used to estimate disease-speci c survival and progression-free survival. Disease-speci c survival was de ned as the time from the surgical procedure to disease-related death and was censored at the date of latest follow-up or death due to other causes. Progression-free survival was de ned as the time from the surgical procedure to local recurrence or metastasis and was censored at the date of latest follow-up or death due to other causes. Prognostic factors were assessed using multivariable Cox proportional hazards models. Categorical variables were compared between groups using chi-square tests; numerical variables were compared using Mann-Whitney U tests. Outcomes are expressed in odds ratios (ORs), hazard ratios (HRs), 95% con dence intervals (CIs) and p-values. Statistical analysis was performed using SPSS version 21 (IBM), with the level of signi cance at p < 0.05.
Pelvic chondrosarcoma
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