Background: Limb salvage after resection of a pelvic sarcoma that
involves the acetabulum represents a surgical challenge. The ideal method of
reconstruction after acetabular resection remains a subject of controversy,
and the outcome in terms of the impact of therapy is still unknown. The
purpose of this study was to determine the impact of surgery on health-related
quality of life and function after acetabular resection.
Methods: Eighty-one patients with a pelvic sarcoma underwent
acetabular resection at a single institution. Functional evaluation and
quality-of-life examination were performed in forty-five patients, and these
patients comprised the study group. Quality of life was assessed with use of
the European Organization for Research and Treatment of Cancer core
quality-of-life questionnaire. Function was assessed with use of the
Musculoskeletal Tumor Society system.
Results: The median age of the patients was 30.4 years at the time
of the acetabular resection and 35.7 years at the time of follow-up. The
median time interval from the index operation to the latest follow-up was
sixty-nine months. At the latest follow-up evaluation, the mean functional
status score was 14.5 points of a maximum of 30 points. In a comparison of
endoprosthetic replacement and hip transposition following resection,
significantly better functional results (p = 0.017) and a lower number of
complications were found in patients who had a hip transposition.
Quality-of-life assessment results were also better in patients with a hip
transposition, especially in role functioning (p = 0.043).
Conclusions: On the basis of the low complication rate and the good
functional and quality-of-life results, hip transposition after acetabular
resection seems to be the optimal technique for treating patients with a
pelvic sarcoma involving the acetabulum.
Level of Evidence: Therapeutic Level III. See
Instructions to Authors for a complete description of levels of evidence.