Comparative study of pelvic sarcoma patients undergoing internal and external hemipelvectomy: A meta-analysis study

Abstract

IntroductionMalignant and giant pelvic tumors are complex and rare, and hemipelvectomies are complex procedures performed for this malignant lesion. Only a few studies had been conducted on the survival and recurrence of pelvic sarcomas patients undergoing internal or external hemipelvectomy. In the present study, we compared internal with external hemipelvectomy in pelvic sarcomas on clinical outcomes by a meta-analysis.MethodsThe survival and recurrence rates of pelvic sarcomas patients were collected from research reports from CNKI, MEDLINE, EMBASE, the Cochrane Database, and Google Scholar until April 2022. The quality of included articles was evaluated by two independent reviewers. Differences between patients undergoing internal and external hemipelvectomy were analyzed based on postoperative survival and recurrence rates.ResultsFive articles were included according to selection criteria. There were 183 patients in total from these studies. Our results showed that there was no significant difference between limb salvage surgery and amputation according to survival; however, patients with internal hemipelvectomy had a lower recurrence rate.ConclusionsInternal hemipelvectomy results in a lower recurrence rate and similar survival rate, while not increasing the risk of metastasis and complications. This study provided more pieces of evidence to support internal hemipelvectomy as a favorable treatment of pelvic sarcomas.

External hemipelvectomy. A last resort operation

“…It is quite difficult to standardize such a rare operation as the external hemipelvectomy. In a recent meta-analysis, only 5 studies of 183 patients were found to compare the results of internal and external hemipelvectomies over a span of 35 years [17]. The majority of even high volume cancer hospitals do not have significant numbers of these operations.…”