Page 47 - Reconstructive Techniques in Musculoskeletal Tumor Surgery

classi cation systems for pelvic chondrosarcoma26, 37. However, neither contain all signi cant variables that were identi ed in our study, suggesting a need for a new staging system, although such a system would need to be validated.
Table 4. Results of Cox proportional hazards models for disease-speci c and progression-free survival 2
Pelvic chondrosarcoma
Disease-speci c survival (DSS), variables:
Tumor grade
Grade 1 Grade 2 Grade 3
Resection margins
Wide Marginal Intralesional
Maximal tumor size
Soft-tissue in ltration (yes vs. no) Hemipelvectomy type (internal vs. external) Progression-free survival (PFS), variables: Tumor grade
Grade 1 Grade 2 Grade 3
Resection margins
Wide Marginal Intralesional
Maximal tumor size
Soft-tissue in ltration (yes vs. no) Hemipelvectomy type (internal vs. external)
Univariable analysis
p-value
- 0.009 0.001
Multivariable analysis
HR 95% CI
Ref -
20.18 2.71 – 150.17 58.94 7.67 – 452.89
p-value
- 0.003 <0.001
- 0.001 <0.001 0.026 0.052 0.409
- 0.011 <0.001
- Ref -
0.029 3.21 0.008 3.56 0.072 1.08 0.088 2.37 0.608 1.38
- Ref 0.035 2.73 <0.001 8.50
1.57 – 1.80 – 1.01 – 0.99 – 0.64 –
6.53 7.02 1.16 5.68 2.97
- Ref - -
0.061 2.32 0.005 2.36 0.062 1.08 0.005 2.41 0.957 1.88
1.29 – 4.16 1.31 – 4.26 1.02 – 1.15 1.12 – 5.20 0.91 – 3.90
0.005 0.004 0.013 0.024 0.091
- 1.26 –
5.90 3.58 – 20.14
Pelvic resections and reconstructions are notorious for the high risk of postoperative complications, of which infection is the most common. Infected pelvic reconstructions may require aggressive surgical treatment, including removal of reconstruction materials or even, although rarely, hindquarter amputation38. Our infection rate (19%) is comparable to previously reported incidences (18% to 32%)18, 38-42. The risk of infection was higher for patients after endoprosthetic reconstruction, although this increased risk may have been caused by the fact that these surgical procedures were the most extensive and complicated ones.
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