Surgical treatment of patients with pelvic bone metastases

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Abstract

Introduction. Pelvic bone metastases are a common complication of malignant tumors, leading to pain, pathological fractures, and decreased quality of life. Surgical treatment plays a key role in palliative care, but the optimal approaches remain controversial.
Aim. To evaluate the results of surgical treatment of patients with pelvic bone metastases, including oncologic and functional outcomes, as well as complication rates.
Materials and methods. A retrospective analysis of 39 patients (21 men, 18 women; median age 55 years) who underwent surgical treatment for metastatic pelvic bone lesions in the period 2002–2022 was performed. The most common localizations were the ilium (10 (25.6 %) cases) and sacrum (13 (33.3 %) cases). A solitary lesion was detected in 33 (84.6 %) patients and multiple bone lesions in 6 (5.4 %) patients. The primary lesion in most cases (in 19 (48.7 %) patients) was kidney cancer. Radical (wide resections) (71.8 % cases) and palliative (decompression and excohleations) (23.1 % cases) methods were used. Survival, complications (according to the Clavien–Dindo classification), pain dynamics (according to the visual analog and Watkins scales) and functional status (according to the Karnofsky scale) were assessed.
Results. Complications developed in 28.2 % of patients, mainly after resections involving the acetabulum (p = 0.029). 
The leading complications were deep infections (8 cases), superficial necrosis (3 cases), which required additional surgical interventions. The median overall survival was 45 months, with solitary metastases – 93 months, with multiple metastases – 20 months (p = 0.019). Intralesional resections were associated with worse survival (p = 0.028). A significant decrease in pain (from 5 to 2 according to the visual analog scale; p <0.001) and improvement in functional status (according to the Karnofsky scale; p = 0.022) were noted. 
Conclusion. Radical resections provide better survival in solitary metastases group, while palliative methods are appropriate for multiple lesions. The choice of tactics requires a multidisciplinary approach, taking into account the prognosis and extent of the lesion.

About the authors

D. I. Sofronov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0001-9557-3685

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

E. A. Sushentsov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: crcspine@rambler.ru
ORCID iD: 0000-0003-3672-1742

Evgeny Alexandrovich Sushentsov

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

D. K. Agaev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-6239-8152

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

K. A. Borzov

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-3512-0390

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

Ya. A. Dzhamukhanova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0009-0006-4043-7698

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

V. E. Popova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0009-0004-7747-7314

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

M. D. Adzhieva

N.I. Pirogov Russian National Research Medical University, Ministry of Health of Russia

1 Ostrovityanova St., Moscow 117513

Russian Federation

V. B. Fedorova

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-4516-3255

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

V. B. Matveev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0001-7748-9527

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

A. K. Valiev

N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0002-2038-3729

24 Kashirskoe Shosse, Moscow 115522

Russian Federation

M. I. Beishembaev

National Center of Oncology and Hematology, Ministry of Health of Kyrgyz Republiс

ORCID iD: 0000-0002-3396-4047

Bld. 8, 92 Isa Akhunbaeva St., Bishkek 720064

Kyrgyzstan

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Copyright (c) 2025 Sofronov D.I., Sushentsov E.A., Agaev D.K., Borzov K.A., Dzhamukhanova Y.A., Popova V.E., Adzhieva M.D., Fedorova V.B., Matveev V.B., Valiev A.K., Beishembaev M.I.

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