Data from: Oncological and surgical outcome after treatment of pelvic sarcomas

Background and Objectives. Treatment of pelvic tumors remains challenging
due to complex anatomy, poor oncological outcome and high complication
rates. We sought to investigate the long-term oncological and surgical
outcome of these patients. Methods. Between 1980 and 2012, 147 patients
underwent surgical treatment for pelvic sarcoma. Histological diagnosis
was Chondrosarcoma in 54, Ewing's Sarcoma/PNET in 37, Osterosarcoma
in 32 and others in 24 patients. Statistical analysis for the evaluation
of oncological and surgical outcome was performed by applying Cox
proportional hazards regression and Fine-Gray regression models for
competing risk (CR) endpoints. Results. The estimated overall survival
(OS) to death was 80%, 45% and 37% at 1, 5 and 10 years, respectively.
Univariate analyses revealed a statistically significant unadjusted
influence of age age (p=0.038; HR=1.01), margin (p=0.043; HR=0.51) and
grade (p=0.001; HR=2.27) on OS. Considering the multivariable model, grade
(p=0.005; HR=3.04) and tumor volume (p=0.014; HR=1.18) presented
themselves as independent prognostic factors on OS. CR analysis showed a
cumulative incidence for major complication of 31% at 5 years.
Endoprosthetic reconstruction had a higher risk for experiencing a major
complication (p<0.0001) and infection (p=0.001). Conclusions.
Pelvic resections are still associated with a high incidence of
complications. Patients with pelvic reconstruction and high volume tumors
are especially at risk. Consequently, a cautious decision-making process
is necessary when indicating pelvic reconstruction, although a restrictive
approach to pelvic reconstruction is not necessarily reasonable when the
other option is major amputation.