Morbidity and functional status of patients with pelvic neurogenic tumors after wide excision

Clin Orthop Relat Res. 2010 Nov;468(11):2948-53. doi: 10.1007/s11999-010-1478-2.

Abstract

Background: We previously reported that over the last 10 years our practice has evolved in the treatment of neurogenic tumors of the pelvis to include a multispecialty team of surgeons, a factor that might decrease morbidity and improve recurrence, survival, and function.

Questions/purposes: Therefore, we (1) assessed the morbidity associated with surgical excision in patients with neurogenic tumors of the pelvis; (2) determined the function of these patients; and (3) determined the rates of local recurrence, metastasis, and overall survival with this new approach.

Methods: We reviewed the records of all 38 patients who had surgery for a pelvic plexus tumor between 1994 and 2005. Twenty one were male. The mean age of all patients was 38 years and median follow up was 2.1 years. Twelve patients had a malignant tumor. We recorded demographic data, postoperative complications, tumor-specific recurrence, and determined survival.

Results: Postoperative complications occurred in nine of the 38 patients (23%): hematoma (n = 3), wound infection or deep abscess (n = 3), and deep venous thrombosis (n = 3). Surgical complications occurred more frequently in patients with malignant disease. Patients with benign tumors had a mean MSTS score of 94%, while survivors of malignant disease had a mean of 57%. For malignant tumors, the 5-year rate of local recurrence was 40%, the estimated 5-year rate of metastasis was 67% and 5-year survival rate was 50%.

Conclusion: Using a team approach, surgical excision provided high functional scores for patients with benign disease with a low rate of complications. In patients with malignant tumors, intentional wide resection is associated with higher morbidity but yields acceptable functional scores.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Bone Neoplasms / mortality
  • Bone Neoplasms / pathology
  • Bone Neoplasms / physiopathology
  • Bone Neoplasms / surgery*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Minnesota
  • Neoplasm Recurrence, Local
  • Neoplasms, Nerve Tissue / mortality
  • Neoplasms, Nerve Tissue / physiopathology
  • Neoplasms, Nerve Tissue / secondary
  • Neoplasms, Nerve Tissue / surgery*
  • Orthopedic Procedures* / adverse effects
  • Pelvic Bones / pathology
  • Pelvic Bones / physiopathology
  • Pelvic Bones / surgery*
  • Recovery of Function
  • Retrospective Studies
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Young Adult