Il trattamento chirurgico delle lesioni metastatiche del bacino

Background: bone metastases are frequent in the pelvis. Historically, the indication for surgery was very limited and is still used in selected cases. Objectives: to analyze surgery and outcome of patients with metastatic carcinoma of the pelvis. Methods: twenty-one patients with metastases of the pelvis, surgically treated between 1985 and 2009, were retrospectively reviewed. Mean age was 56 years. All patients were treated with combined therapies (radiotherapy and/or chemoteraphy and/or embolization) with the exception of one patient treated with surgery only for the inability to perform other treatments because of intercurrent medical problems unrelated with surgery. Surgery included intralesional resection (seven patients), marginal resection (two patients), wide resection (eleven patients), and external hemipelvectomy (one patient). Results: mean follow-up was 27 months (range, 1.5-152 months). Six patients were alive with no evidence of disease, 4 patients were alive with disease, and 11 patients died. The survival rate was 63% at 2 years and 30% at 5 years. Local recurrence rate was 33.3%. Conclusion: multidisciplinary treatment with radio- and chemotherapy is recommended for osseous metastases of the pelvis. Surgery has selected indications, with the aim of improving quality of life and functional outcome.