SIOP 2013 Scientific Programme + Index

Abstract

Purpose/Objective: The analysis aims to evaluate the impact of hemipelvectomy on the outcomes in patients with Ewing Sarcoma there located. Material(s) and Method(s): Twenty-four patients aged from 2.3 to 19.6 years were treated according to EE99 and EE2008 (2000-2012) for pelvic Ewing Sarcoma. Tumors were located in the hip-joint in 16 pts, in pubic bone in 3, in ischium in 3 and in pubic & ischium in 2. Twelve patients had distant metastasis at initial diagnosis. Follow-up ranged from 9 months to 9.1 years. After neoadjuvant chemotherapy, all patients underwent internal hemipelvectomy with following reconstructions: allogenic bone graft/14, endoprosthesis/6, non-absorbable mesh to restore the hip-joint/4. Postoperatively, chemotherapy was continued and in 13/24 patients consolidated with aBMT. Local radiotherapy was used in 15 patients. Result(s): Perioperative period was uneventful, however late complications occurred in 8 (surgery-related infections/2 and wound necrosis and/or dehiscences/6). In one case, the complications led to external hemipelvectomy 2 years after primary treatment. Four patients had local and two distant relapses and died; only one of them had microscopically incomplete surgery. Remaining 3 patients after microscopically incomplete resections are alive. 5-year EFS was 67% and OS 72%. Functionally, all patients were ambulant: 14 without crutches, 4 with one crutch and 6 with 2 crutches. Conclusion(s): Internal hemipelvectomy offers similar chance for cure as more mutilating procedures with reasonable rate of complications and better function.