Outcome of type 4 pelvic resection and reconstruction with a high hip center in malignant pelvic tumours: A case series and short-term review.

Abstract

BackgroundType 4 pelvic resections for malignant pelvic tumours are complex procedures requiring meticulous surgical planning to balance oncological control and preservation of hip joint function. Reconstruction with a high hip centre is one strategy to restore a mobile hip joint after ilium resection.MethodsThis retrospective case series reviews eight patients (5 males, 3 females; mean age 52.5 years, range 36-70) who underwent Type 4 pelvic resection and high hip centre reconstruction at a single institution. Tumour histologies included chondrosarcoma (<i>n</i> = 5), Ewing's sarcoma (<i>n</i> = 1), malignant hemangiopericytoma (<i>n</i> = 1), and metastatic papillary thyroid carcinoma (<i>n</i> = 1). The mean follow-up duration was 44 months (24-69 months).ResultsThe average surgical time was 4 h (range 3.5-6 h) with a mean estimated blood loss of 1500 ml (range 1200-2000 ml). Complications occurred in 50% of cases, including deep wound infection (<i>n</i> = 1), seroma formation (<i>n</i> = 2), and implant failure (<i>n</i> = 1). There were no local recurrences. Oncological outcomes showed that 3 patients died due to disease progression, 1 remains alive with disease, and 4 are disease-free. Functional outcomes were assessed using the MSTS and TESS scoring systems, with mean scores of 63.4% (range 33.3%-80.3%) and 65.7% (range 25%-86.6%), respectively.ConclusionType 4 pelvic resection with high hip centre reconstruction is a viable option for managing select malignant pelvic tumours, offering reasonable short-term oncological control and functional outcomes despite a notable complication rate. Careful patient selection and surgical planning remain essential.