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Acta Chirurgiae Orthopaedicae Et... Aug 1970
Topics: Bone Neoplasms; Czechoslovakia; Humans; Neoplasm Metastasis; Pelvic Bones; Pelvic Neoplasms; Prognosis
PubMed: 5456378
DOI: No ID Found -
International Journal of Cancer Aug 1998We have previously demonstrated in primary cancer of the uterine cervix that tumor hypoxia, as determined polarographically, is strongly associated with clinical...
We have previously demonstrated in primary cancer of the uterine cervix that tumor hypoxia, as determined polarographically, is strongly associated with clinical malignant progression of the disease. Having applied a similar methodological approach to investigate loco-regional relapses, we found a pronounced shift to more hypoxic oxygenation profiles in the recurrent tumors than in the primary tumors. Median pO2 values in 53 pelvic recurrences were significantly lower than the median pO2 values of 117 primary tumors of comparable sizes (7.1 +/- 1.1 mmHg vs. 12.1 +/- 1.0 mmHg, p = 0.0013). The differences in tumor oxygenation between primary and recurrent tumors mirrored the differences in the patients' 5-year survival probabilities. In the cohort of patients with pelvic relapses, median tumor pO2 < 4 mmHg indicated a significantly shorter median survival time as compared to median tumor pO2 > or = 4 mmHg. Our results further support our thesis that in cervical cancer, tumor hypoxia and clinical aggressiveness in terms of resistance to therapy and tumor dissemination, are interrelated.
Topics: Adenocarcinoma; Adult; Aged; Carcinoma, Adenosquamous; Carcinoma, Squamous Cell; Female; Humans; Middle Aged; Neoplasm Recurrence, Local; Oxygen; Partial Pressure; Pelvic Neoplasms; Polarography; Uterine Cervical Neoplasms
PubMed: 9699528
DOI: 10.1002/(sici)1097-0215(19980821)79:4<365::aid-ijc10>3.0.co;2-4 -
JAMA May 1977
Topics: Aged; Dantrolene; Humans; Hydantoins; Leg; Male; Muscle Cramp; Pelvic Neoplasms
PubMed: 576933
DOI: 10.1001/jama.1977.03270490018002 -
Journal of Pediatric Surgery May 2000Cervical, thoracic, and pelvic neuroblastomas are regarded as having a better outcome than abdominal primaries. The aim of the study was to analyze the results of...
BACKGROUND/PURPOSE
Cervical, thoracic, and pelvic neuroblastomas are regarded as having a better outcome than abdominal primaries. The aim of the study was to analyze the results of treatment of pelvic neuroblastomas in our institution.
METHODS
The authors reviewed the records of 284 patients with neuroblastoma treated in our hospital during the period 1983 through 1998 and identified 17 (6%) with pelvic tumors. The revised International Neuroblastoma Staging System was used.
RESULTS
There were 6 patients with stage 1 disease, 8 with stage 2, 2 with stage 3, and 1 with stage 4 disease. Intraspinal extension of the tumor was present in 7 patients (41%). Except for one child with stage 4 disease, all patients underwent an attempt of tumor excision, and 6 had a complete resection. All 7 patients with intraspinal tumor survived. Permanent postoperative neurological complications occurred in 6 patients (35%). These included sciatic nerve palsy, urinary and fecal incontinence, neuropathic bladder, and leg weakness or nerve root injury L4-S1. Three of 17 patients died, but 1 fatality was unrelated to the tumor. The overall survival rate was 82% and was not influenced by the completeness of tumor resection.
CONCLUSIONS
The survival of nonmetastatic pelvic neuroblastoma in our institution is good despite incomplete tumor resection. Intraspinal extension is not a negative prognostic factor. Considering the high incidence of permanent neurological damage after surgery and the generally favorable biological characteristics of these tumors, surgical treatment should not be overaggressive.
Topics: Antineoplastic Combined Chemotherapy Protocols; Child; Child, Preschool; Combined Modality Therapy; Disease Progression; Fecal Incontinence; Female; Follow-Up Studies; Humans; Infant; Male; Neoplasm Staging; Neuroblastoma; Pelvic Neoplasms; Peripheral Nervous System Diseases; Prognosis; Radiotherapy; Retrospective Studies; Risk Factors; Surgical Procedures, Operative; Survival Analysis; Treatment Outcome; Urinary Incontinence
PubMed: 10813335
DOI: 10.1053/jpsu.2000.6076 -
Clinical Imaging 2004MRI is multiplanar, has large field of view, superior contrast resolution and no known adverse effect on the reproductive potential of ovaries. It is useful for...
MRI is multiplanar, has large field of view, superior contrast resolution and no known adverse effect on the reproductive potential of ovaries. It is useful for characterizing solid, cystic or necrotic tissue, blood and fat. Contrast-enhanced MRI is also a comprehensive examination of the entire pelvis including lymph nodes, peritoneum, pelvic sidewalls, bone and muscles. It provides information about areas difficult to assess surgically, can refine staging classification, assists in planning surgery or radiotherapy and may be more cost-effective by limiting use of surgery. This is a pictorial essay of MRI assessment of female pelvic neoplasm.
Topics: Contrast Media; Female; Genital Neoplasms, Female; Humans; Magnetic Resonance Imaging; Middle Aged; Pelvic Neoplasms
PubMed: 15050230
DOI: 10.1016/S0899-7071(03)00116-5 -
Diseases of the Colon and Rectum Jul 2009Lateral pelvic recurrence is considered a poor prognostic variable and a relative contraindication to surgery because of the difficulty in achieving clear margins. The...
PURPOSE
Lateral pelvic recurrence is considered a poor prognostic variable and a relative contraindication to surgery because of the difficulty in achieving clear margins. The aim of this study was to outline our surgical approach to lateral pelvic sidewall involvement and assess the oncologic and long-term outcomes.
METHODS
A retrospective review of a prospective database was performed. Patient demographics, cancer and operative details, intent, margins, lymph node status, rerecurrence at resection site, follow-up, living and death details were assessed.
RESULTS
En bloc lateral pelvic wall dissection and vascular resection with pelvic exenteration was performed in 36 patients of 107 exenterations. All patients underwent surgery with curative intent. Negative margins were achieved in 19 patients (53%). Ten patients (28%) developed recurrence at the site of resection compared with 26 patients (72%) who remained disease free at the site of surgery. Sixteen patients (46%) are disease-free with the average disease-free interval of 30 months. Twenty-five patients (69%) are alive with a mean follow-up of 19 months. No mortalities occurred in this cohort of patients.
CONCLUSION
Despite the complexity of this technique, it is safe and feasible. Careful preoperative radiologic assessment and a multidisciplinary approach are paramount to achieving clear margins.
Topics: Adult; Aged; Aged, 80 and over; Carcinoma; Cohort Studies; Databases, Factual; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Pelvic Exenteration; Pelvic Neoplasms; Pelvis; Retrospective Studies; Sarcoma; Treatment Outcome
PubMed: 19571697
DOI: 10.1007/DCR.0b013e3181a73f48 -
Journal of Surgical Oncology Jan 2000Primary tumors of the bone and soft tissue of the pelvis are rare. Proper surgical treatment requires a fundamental knowledge of the biology of malignant musculoskeletal... (Review)
Review
Primary tumors of the bone and soft tissue of the pelvis are rare. Proper surgical treatment requires a fundamental knowledge of the biology of malignant musculoskeletal neoplasms. This understanding allows stratification of sarcomas into a staging system. In addition to prognostic value, the careful staging of the neoplasms dictates the type of surgical margins necessary and guides in the use of adjuvant therapy. Limb salvage techniques developed for the reconstruction of major extremity structural deficits can be used for reconstruction of the pelvis. This review first addresses the biologic behavior and staging of malignant musculoskeletal neoplasms. The surgical techniques employed for the resection and the reconstruction of the pelvis are then discussed.
Topics: Arthroplasty; Bone Neoplasms; Carcinoma; Humans; Neoadjuvant Therapy; Neoplasm Staging; Pelvic Bones; Pelvic Neoplasms; Prognosis; Plastic Surgery Procedures; Sarcoma
PubMed: 10649279
DOI: 10.1002/(sici)1096-9098(200001)73:1<39::aid-jso11>3.0.co;2-q -
Archives of Surgery (Chicago, Ill. :... Apr 1987The management of regional tumor recurrence in the pelvis traditionally has been a difficult problem for surgeons and oncologists. The only meaningful therapy for these...
The management of regional tumor recurrence in the pelvis traditionally has been a difficult problem for surgeons and oncologists. The only meaningful therapy for these patients is a potentially curative re-resection. The records and operative reports of 29 patients with regional pelvic tumor recurrence treated between 1981 and 1986 were reviewed. The operative procedures performed included three bowel resections, six abdominoperineal resections, eight pelvic exenterations, eight resections of tumor recurrence, and four conservative procedures. There was one operative death in this group. Significant morbidity was noted in the group but was clustered in a small number of patients operated on early in the series. The median follow-up in this series was 13 months (range, two to 51 months). Nineteen (65%) of the patients are surviving at a median follow-up of ten months (range, two to 51 months). The median survival (following resection) in the ten patients (35%) who died was 18 months. In 15 (52%) of the patients, a complete resection was performed. In this group, the survival is 80% with a median follow-up of 11 months. Seven (37%) are surviving with no evidence of disease. Palliation of symptoms occurred in 23 (79%) of the 29 patients. Radical resection of tumor recurrence in the pelvis can be performed with acceptable mortality and complication rates. This therapy should be considered for further clinical trials combining surgical and adjuvant therapy in patients with regional pelvic tumor recurrence.
Topics: Adult; Aged; Combined Modality Therapy; Female; Follow-Up Studies; Humans; Middle Aged; Neoplasm Recurrence, Local; Palliative Care; Pelvic Neoplasms; Reoperation
PubMed: 2436595
DOI: 10.1001/archsurg.1987.01400160083013 -
Medicine Sep 2019Pelvic tumor had great impact on patients' quality of life. After tumor resection, how to accurately fill bone defect remained challenging for orthopedic surgeons. Due...
RATIONALE
Pelvic tumor had great impact on patients' quality of life. After tumor resection, how to accurately fill bone defect remained challenging for orthopedic surgeons. Due to lack of individual design, high incidence of prosthetic mismatching, and loosening were reported in pelvic reconstruction surgery with conventional modular prostheses. Nowadays, with rapid development of three-dimensional (3D) print technology, pelvic prostheses could be designed according to patients' own anatomy. The objective of this study was to describe the application of 3D printed customized hemi-pelvic prosthesis for patients with pelvic tumor.
PATIENT CONCERNS
A 62-year-old female had developed severe right joint pain without obvious inducement from 5 months before she sought medical advice. Pain, swelling, and limited range of motion of right joint were founded during physical examination.
DIAGNOSIS
The patients were diagnosed as "right acetabulum metastatic carcinoma" INTERVENTION:: 3D printed titanium alloy hemi-pelvic prosthesis was designed according the morphology of unaffected side hemi-pelvis and subsequently implanted in surgery to reconstruct the pelvis. 3D printed osteotomy guide and pelvic model were also manufactured and applied to improve accuracy of osteotomy and reduce operation time. X-Ray of pelvis, Harris score, musculoskeletal tumor society score (MSTS) and The MOS item short from health survey (SF-36) were recorded during the period of preoperation, 1, 3, 6, 12 months follow-up after operation.
OUTCOMES
3D printed hemi-pelvic prosthesis matched precisely with pelvis and implanted successfully. There was no sign of prosthetic loosening within 12 months' follow-up. No sign of peri-prosthetic infection from laboratory examination. Harris score, MSTS, and SF-36 were gradually increasing during follow-up period.
LESSONS
Satisfactory effect of pelvic reconstruction could be achieved by 3D printed hemi-pelvic prostheses. It also provided a promising way to the treatment of pelvic tumor in similar cases.
Topics: Female; Humans; Middle Aged; Neoplasm Metastasis; Pelvic Neoplasms; Printing, Three-Dimensional; Prosthesis Design; Prosthesis Implantation; Plastic Surgery Procedures
PubMed: 31490360
DOI: 10.1097/MD.0000000000016658 -
Langenbeck's Archives of Surgery Jun 2020In an era of personalised medicine, there is an overwhelming effort for predicting patients who will benefit from extended radical resections for locally advanced pelvic... (Observational Study)
Observational Study
PURPOSE
In an era of personalised medicine, there is an overwhelming effort for predicting patients who will benefit from extended radical resections for locally advanced pelvic malignancy. However, there is paucity of data on the effect of comorbidities and postoperative complications on long-term overall survival (OS). The aim of this study was to define predictors of 1-year and 5-year OS.
METHODS
Data were collected from prospective databases at two high-volume institutions specialising in beyond TME surgery for locally advanced and recurrent pelvic malignancies between 1990 and 2015. The primary outcome measures were 1-year and 5-year OS.
RESULTS
A total of 646 consecutive extended radical resections were performed between 1990 and 2015. The majority were female patients (371, 57.4%) and the median age was 63 years (range 19-89 years). One-year OS, primary rectal adenocarcinoma had the best survival while recurrent colon cancer had the worse survival (p = 0.047). The 5-year OS between primary and recurrent cancers were 64.7% and 53%, respectively (p = 0.004). Poor independent prognostic markers for 5-year OS were increasing ASA score, cardiovascular disease, recurrent cancers, ovarian cancers, pulmonary embolus and acute respiratory distress syndrome. A positive survival benefit was demonstrated with preoperative radiotherapy (HR 0.55; 95% CI 0.4-0.75, p < 0.001).
CONCLUSION
Patient comorbidities and specific complications can influence long-term survival following extended radical resections. This study highlights important predictors, enabling clinicians to better inform patients of the potential short- and long-term outcomes in the management of locally advanced and recurrent pelvic malignancy.
Topics: Adult; Aged; Aged, 80 and over; Female; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Pelvic Neoplasms; Postoperative Complications; Retrospective Studies; Risk Factors; Survival Rate; Young Adult
PubMed: 32533361
DOI: 10.1007/s00423-020-01895-y