Surgical treatment for pelvic bone metastases

Bone metastases are one of the important problems of modern orthopedic oncology. Because of the improvement of the methods of systemic drug treatment of malignant tumors, the overall duration of life expectancy of patients with generalized cancer, including bone metastases, can be up to 12–18 months and more. Metastases, including pelvic bone metastases, reduce the quality of life of patients, not only causing pain syndrome (PS), but also significantly placing restrictions on patients’ movement, often leading to disability. The possibilities of surgical correction of modern oncoortopedia can prevent pathological fractures, reduce PS and, as a result, stabilize or improve the functional status of patients. The aim is to evaluate the results of treatment of patients with metastases of various solid tumors in pelvic bone. Materials and methods . The analysis of the treatment of 67 patients who underwent various types of surgery for pelvic ring metastases. The average age of patients was 55.5 years (from 23 to 75 years). 51 (76.12%) patients with multiple metastases underwent minimally invasive palliative surgery. Radical surgery was performed in16 (23.88%) patients with solitary mass. Results . The average blood loss during radical surgery was 1969 ml (from 150 to 4000 ml). The edges of resection during all surgeries are negative (R0). Six patients showed progression after the treatment of the disease. It was noted that 46 (90%) patients had a significant reduction in PS, up to complete disappearance, that allowed 42 (82%) patients to reduce the intake of analgesic drugs or completely abandon them, after minimally invasive palliative surgery. Conclusion . In case of solitary pelvic bone metastases is necessary to perform radical surgery to achieve maximum oncological and functional results. In patients with multiple metastases in order to reduce PS and improve the quality of life rationally should be performed minimally invasive surgery, this will allow to start systemic drug treatment as soon as possible.