Complications and outcome of external hemipelvectomy in the management of pelvic tumors

Background: Although the technique of external hemipelvectomy has been adequately described, little is known about its complications and late results. Design: Retrospective review of 68 external hemipelvectomies performed at our Institute between 1973 and 1994. Materials and methods: Eleven patients had bone tumor; 39 patients, soft-tissue sarcoma; seven patients, melanoma; 10 patients, squamous cell carcinoma; and one patient, giant neurofibroma. In 48 (71%) patients, the intent was curative. In 17 cases, the hemipelvectomy was extended. Results: Postoperative complications occurred in 36 (53%) patients, including flap necrosis in 11 (16%), wound infection in 24 (35%), and other complications in 12 (18%). Four (6%) patients died postoperatively. The average hospital stay after curative versus palliative resection was 39 versus 24 days, Only three (5%) patients were able to use a prosthesis, whereas 55 (81%) used crutches, six (9%) remained wheelchair bound, and four patients (6%) spent most of the time in bed. Local recurrence occurred in 35% of the patients. The estimated 5-year survival for curatively resected patients was 21%. Conclusions: External hemipelvectomy is a procedure with considerable morbidity and is indicated for only a minority of far-advanced tumors, It offers a chance of palliation and possibly cure when lesser surgical options have been exhausted.