Outcomes of Hemipelvectomy for Pelvic Chondrosarcoma: A Single-Institution Case Series of 15 Patients

Chondrosarcoma Hemipelvectomy: A Case Series
Vol. 21 No. 2 : 2026 (1166-1176)

Syurahbil Abdul Halim Syurahbil Abdul Halim
Syed Muhammad Syed Abdullah Syed Muhammad Syed Abdullah
Sahran Yahaya Sahran Yahaya
Nor Azman Mat Zin Nor Azman Mat Zin
Mohd Ariff Sharifudin Mohd Ariff Sharifudin

Abstract
Chondrosarcoma is a malignant bone tumour that is largely resistant to chemotherapy and radiotherapy, leaving surgery as the only effective treatment. Pelvic chondrosarcomas pose unique challenges due to anatomical complexity, delayed presentation, and the difficulty of achieving negative surgical margins. This case series reviews 15 patients treated at a tertiary referral centre over ten years, focusing on surgical outcomes and complications of limb-salvage (internal hemipelvectomy, IH) compared with hindquarter amputation (external hemipelvectomy, EH). Eleven patients underwent IH and four EH, with two requiring conversions from IH to EH due to persistent infection. The mean symptom duration was 12.3 months. Clear surgical margins were achieved in eight patients (53.3%). At a mean follow-up of 47.6 months, 10 patients were alive, with eight of them being disease-free. Complications were universal, with wound infection being the most frequent (13 of 15 patients). Functional outcomes, measured by Musculoskeletal Tumor Society scores, were highly variable (final mean: 59.6%, range 6.7-100). Time to first ambulation tended to be longer for EH patients. While IH can yield good function, it carries a high risk of major complications. EH provides definitive control in complex cases but results in profound functional impairment. Careful patient selection is paramount in managing this difficult disease.
Keywords : Chondrosarcoma; hemipelvectomy; pelvic neoplasms; postoperative complications; surgical margins,
Abstrak
Kondrosarkoma ialah kanser tulang yang kebanyakannya refraktori terhadap kemoterapi dan radioterapi, menjadikan pembedahan sebagai satu-satunya rawatan yang berkesan. Kondrosarkoma pelvis memberikan cabaran unik disebabkan kerumitan anatomi, kelewatan pesakit mendapatkan rawatan serta kesukaran untuk mencapai margin pembedahan yang negatif. Siri kes ini meneliti 15 pesakit yang dirawat di sebuah pusat rujukan tertiari sepanjang tempoh sepuluh tahun, dengan memberi fokus kepada hasil pembedahan dan komplikasi bagi penyelamatan anggota (hemipelvektomi dalaman, IH) berbanding amputasi hindquarter (hemipelvektomi luaran, EH). Sebelas pesakit menjalani IH dan empat pesakit menjalani EH, dengan dua kes memerlukan penukaran dari IH ke EH akibat jangkitan berterusan. Tempoh purata gejala ialah 12.3 bulan. Margin pembedahan yang negatif dicapai dalam lapan pesakit (53.3%). Pada tempoh susulan purata selama 47.6 bulan, 10 pesakit masih hidup dengan lapan daripadanya bebas penyakit. Semua pesakit mengalami komplikasi, dengan jangkitan luka merupakan komplikasi yang paling kerap berlaku (13 daripada 15 pesakit). Hasil fungsi yang diukur menggunakan skor Musculoskeletal Tumor Society, adalah sangat pelbagai (min akhir: 59.6%, julat 6.7-100). Tempoh sehingga ambulasi pertama cenderung lebih lama bagi pesakit EH. Walaupun IH berpotensi memberikan hasil fungsi yang baik, ia mempunyai risiko komplikasi major yang tinggi. EH memberikan kawalan definitif bagi kes-kes kompleks tetapi mengakibatkan kecacatan fungsi yang ketara. Pemilihan pesakit yang teliti adalah amat penting dalam pengurusan penyakit yang sukar ini.
Kata Kunci : Hemipelvektomi; komplikasi pascaoperasi; kondrosarkoma; margin pembedahan; neoplasma pelvis,

Correspondance Address
*Correspondence: ariffsharifudin@unisza.edu.my / dr.ariff.s@gmail.com


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