Sculpting Hope: Exploring Challenges, innovations and Future Horizons in treatment of Pelvic Bone Sarcomas

Authors

  • Muhammad Zoha Farooq Fellow Orthopedic and Musculoskeletal Tumors Department of Surgical Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore

Keywords:

Pelvic Bone Sarcomas, Challenges, Modern Advances

Abstract

Musculoskeletal tumors of the Pelvis can either be Primary Bone tumors or Metastatic Lesions. The most frequent are Osteosarcomas, Ewings Sarcoma, Chondrosarcoma, and Metastatic carcinoma. The field of Pelvic Oncological surgery has advanced in recent years due to the progress in Anesthesia, Peri-Operative care, and Improved Imaging capabilities, particularly the use of Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and the development of adjuvant chemo and radiotherapy.  Pelvic sarcomas are typically a challenge when it comes to resection of these tumors, this is multifactorial, like proximity of the tumor to the Genitourinary structures, adjacent neurovascular bundles, size of the tumor, difficult anatomy of the Pelvis, high level of surgical skills required for resection and reconstruction and associated high morbidity and mortality with Pelvic Surgeries.

References

Laitinen MK, Parry MC, Morris GV, Jeys LM. Pelvic bone sarcomas, prognostic factors, and treatment: A narrative review of the literature. Scandinavian Journal of Surgery. 2023;112(3):206-215. doi:10.1177/14574969231181504

Jay S. Lee, Ciara M. Kelly, Edmund K. Bartlett, Management of pelvic sarcoma, European Journal of Surgical Oncology, Volume 48, Issue 11, 2022, Pages 2299-2307, ISSN 0748-7983, doi:10.1016/j.ejso.2022.09.011.

Soares do Brito J, Esperança-Martins M, Abrunhosa-Branquinho A, Melo-Alvim C, Lopes-Brás R, Janeiro J, Lopez-Presa D, Fernandes I, Portela J, Costa L. Management of Unresectable Localized Pelvic Bone Sarcomas: Current Practice and Future Perspectives. Cancers (Basel). 2022 May 22;14(10):2546. doi: 10.3390/cancers14102546. PMID: 35626150; PMCID: PMC9139258.

Binitie O, Tejiram S, Conway S, Cheong D, Temple HT, Letson GD. Adult soft tissue sarcoma local recurrence after adjuvant treatment without resection of core needle biopsy tract. Clin Orthop Relat Res. 2013 Mar;471(3):891-8. doi: 10.1007/s11999-012-2569-z. PMID: 22968531; PMCID: PMC3563812.

Berger-Richardson D, Swallow CJ. Needle tract seeding after percutaneous biopsy of sarcoma: Risk/benefit considerations. Cancer. 2017 Feb 15;123(4):560-567. doi: 10.1002/cncr.30370. Epub 2016 Nov 2. PMID: 27859013.

Fujiwara T, Lex JR, Stevenson JD, Tsuda Y, Clark R, Parry MC, Grimer RJ, Jeys LM. Surgical treatment for pelvic Ewing sarcoma: What is a safe and functional acetabular reconstruction when combined with modern multidisciplinary treatments? J Surg Oncol. 2019 Nov;120(6):985-993. doi: 10.1002/jso.25660. Epub 2019 Aug 5. PMID: 31381161.

Tsuda Y, Evans S, Stevenson JD, Parry M, Fujiwara T, Laitinen M, Outani H, Jeys L. Is the Width of a Surgical Margin Associated with the Outcome of Disease in Patients with Peripheral Chondrosarcoma of the Pelvis? A Multicenter Study. Clin Orthop Relat Res. 2019 Nov;477(11):2432-2440. doi: 10.1097/CORR.0000000000000926. PMID: 31453886; PMCID: PMC6903848.

Bus MP, Szafranski A, Sellevold S, Goryn T, Jutte PC, Bramer JA, Fiocco M, Streitbürger A, Kotrych D, van de Sande MA, Dijkstra PD. LUMiC® Endoprosthetic Reconstruction After Periacetabular Tumor Resection: Short-term Results. Clin Orthop Relat Res. 2017 Mar;475(3):686-695. doi: 10.1007/s11999-016-4805-4. PMID: 27020434; PMCID: PMC5289170.

Wafa H, Grimer RJ, Jeys L, Abudu AT, Carter SR, Tillman RM. The use of extracorporeally irradiated autografts in pelvic reconstruction following tumour resection. Bone Joint J. 2014 Oct;96-B(10):1404-10. doi: 10.1302/0301-620X.96B10.33470. PMID: 25274929.

Puri A, Pruthi M, Gulia A. Outcomes after limb sparing resection in primary malignant pelvic tumors. Eur J Surg Oncol. 2014 Jan;40(1):27-33. doi: 10.1016/j.ejso.2013.10.017. Epub 2013 Nov 5. PMID: 24239184.

Wong KC, Kumta SM. Joint-preserving tumor resection and reconstruction using image-guided computer navigation. Clin Orthop Relat Res. 2013 Mar;471(3):762-73. doi: 10.1007/s11999-012-2536-8. PMID: 22948524; PMCID: PMC3563823.

Gerbers JG, Stevens M, Ploegmakers JJ, Bulstra SK, Jutte PC. Computer-assisted surgery in orthopedic oncology. Acta Orthop. 2014 Dec;85(6):663-9. doi: 10.3109/17453674.2014.950800. Epub 2014 Aug 20. PMID: 25140984; PMCID: PMC4259032.

Benady A, Gortzak Y, Sofer S, Ran Y, Rumack N, Elias A, Efrima B, Golden E, Segal O, Merose O, Sternheim A, Dadia S. Internal Hemipelvectomy for primary bone sarcomas using intraoperative patient specific instruments- the next step in limb salvage concept. BMC Musculoskelet Disord. 2022 Nov 24;23(1):1012. doi: 10.1186/s12891-022-05918-1. PMID: 36424560; PMCID: PMC9685900.

Downloads

Published

2024-03-29

How to Cite

Sculpting Hope: Exploring Challenges, innovations and Future Horizons in treatment of Pelvic Bone Sarcomas. (2024). Journal of Pakistan Orthopaedic Association, 36(01), 01-03. https://jpoa.org.pk/index.php/upload/article/view/850

Similar Articles

1-10 of 83

You may also start an advanced similarity search for this article.