From 1970 through 1985, at the Mayo Clinic, sixty patients had operative
treatment, with salvage of the limb, for a primary malignant tumor of the
pelvis. Chondrosarcoma, osteosarcoma, and fibrosarcoma were common
diagnoses. There were twenty-three iliosacral, twenty-five acetabular, and
twelve ischiopubic lesions. Most of the resections were done with a wide
margin and disruption of femorosacral continuity. Reconstruction included
ten iliosacral, fourteen iliofemoral, and three ischiofemoral arthrodeses,
and approximately 50 per cent of the procedures resulted in fusion. The
average length of follow-up exceeded five years. Seventeen per cent of the
patients, primarily those in whom an iliosacral lesion extended into the
sacrum or along the spinal column, had a local recurrence. Twenty-one
patients (37 per cent) had metastasis. The best functional results were
seen after resections in which femorosacral continuity was maintained or
reconstructed. If satisfactory margins can be achieved by the excision of a
pelvic tumor, salvage of the limb is justified from both an oncological and
a functional standpoint.