7.P.13 THE INTERPELVIC-ABDOMINAL AMPUTATION IN COMBINED TREATMENT OF MALIGNANT TUMORS OF THE PELVIC WAIST

Abstract

The results of treatment of 45 patients with malignant bone tumors and soft tissues of thigh proximal part and pelvis have been analyzed in the work. From 45 male patients −37 (82%), women −8 (18%). Patients’ age varied from 17-to 53 years old, in average was-33 year old. In 22 patients the tumor localized in thigh proximal part, in 17 – in the bone and soft pelvic tissues, in 2- in the buttock part and in 4- noticed metastasis lesion inguinaliliac lymph nodes. In 5 observations histological type composed from malignant gigantic cellular tumor, in 8 osteogen sarcomas, in 11-hondro-sarcomas, in 5-Ewing’s sarcomas, in 4 – fibrosarcoma of soft tissues, in 4-rabdomiosarcomas, in 1- angiosar-coma of soft tissues, in 1-leiomyosarcomas, in 1-synovial sarcomas, in 1- polymorph cellular sarcomas of soft tissues and in 4- marked metastasis lesion (mainly flat cellular skin cancer) lymph nodes of inguinal-iliac part. The complex diagnostic measures including clinic, X-ray and ultrasound diagnostics, angiography, computed magnetic – resonance tomography and morphologic investigations were carried out with all patients.

A size of tumor process is 250–450cm3. In all cases carried out lymph dissection with removing of cellular tissue of pelvis till bifurcation of abdominal aorta, in 5 additionally are made sacrum resection. Duration of operational interference was from 150 to 189 minutes, and blood lost – from 1200 to 1800 ml. There were no mortality outcomes during the operation. The patients have been observed from 1 year till 12 years. During observation period from 45 patients in 4 (8%) have been determined local recurrence, in 12 (26%) – separated metastasis and in 2 (4%) –simultaneously determined recurring and separated metastasis. Findings of 3 and 5 years survival are 44,6% and 33,5%.

So, interpelvic-abdominal amputation prolongs patients’ surveillance, which before is considered hopeless and mainly undergone palliative chemotherapy and symptomatic treatment.