scholarly journals Brain Tumor Resection in Elderly Patients: Potential Factors of Postoperative Worsening in a Predictive Outcome Model

Cancers ◽  
2021 ◽  
Vol 13 (10) ◽  
pp. 2320
Author(s):  
Paolo Ferroli ◽  
Ignazio Gaspare Vetrano ◽  
Silvia Schiavolin ◽  
Francesco Acerbi ◽  
Costanza Maria Zattra ◽  
...  
Keyword(s):  
Brain Tumor ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Performance Status ◽  
Tumor Resection ◽  
Patient Specific ◽  
Invasive Treatment ◽  
Tertiary Referral Center ◽  
Surgical Complexity

The decision of whether to operate on elderly patients with brain tumors is complex, and influenced by pathology-related and patient-specific factors. This retrospective cohort study, based on a prospectively collected surgical database, aims at identifying possible factors predicting clinical worsening after elective neuro-oncological surgery in elderly patients. Therefore, all patients ≥65 years old who underwent BT resection at a tertiary referral center between 01/2018 and 12/2019 were included. Age, smoking, previous radiotherapy, hypertension, preoperative functional status, complications occurrence, surgical complexity and the presence of comorbidities were prospectively collected and analyzed at discharge and the 3-month follow-up. The series included 143 patients (mean 71 years, range 65–86). Sixty-five patients (46%) had at least one neurosurgical complication, whereas 48/65 (74%) complications did not require invasive treatment. Forty-two patients (29.4%) worsened at discharge; these patients had a greater number of complications compared to patients with unchanged/improved performance status. A persistent worsening at three months of follow-up was noted in 20.3% of patients; again, this subgroup presented more complications than patients who remained equal or improved. Therefore, postoperative complications and surgical complexity seem to influence significantly the early outcome in elderly patients undergoing brain tumor surgery. In contrast, postoperative complications alone are the only factor with an impact on the 3-month follow-up.

Efficacy and safety of surgery for spontaneous pneumothorax in elderly patients

2019 ◽  
Author(s):  
Shunichi Nagata ◽  
Mitsugu Omasa ◽  
Kosuke Tokushige ◽  
Takao Nakanishi ◽  
Hideki Motoyama
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Postoperative Complications ◽  
Elderly Patients ◽  
Spontaneous Pneumothorax ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Efficacy And Safety ◽  
Air Leaks ◽  
Grade 3

Abstract OBJECTIVES There is no clear consensus on the surgical indications for spontaneous pneumothorax in elderly patients. In this study, we aimed to assess the efficacy and safety of surgical treatment of spontaneous pneumothorax in patients aged ≥70 years. We also sought to identify the risk factors for postoperative prolonged air leaks and complications in such patients. METHODS Data pertaining to 104 elderly patients who underwent surgery out of 206 patients (aged ≥70 years) who were diagnosed with spontaneous pneumothorax at our institution between 1994 and 2018 were retrospectively reviewed. The incidences of postoperative persistent air leaks (≥2 days) and postoperative complications (≥grade 3; Clavien–Dindo classification) were analysed for efficacy and safety assessment, respectively. RESULTS Median postoperative air leaks continued for 0 days (range 0–25); 14.4% patients developed ≥grade 3 postoperative complications. On the basis of results of multivariable analysis, it was observed that a higher PaCO2 level was significantly associated with prolonged postoperative air leaks [odds ratio (OR) 1.08, 95% confidence interval (CI) 1.00–1.17; P = 0.047]. Poorer performance status was associated with a significantly increased risk of postoperative complications, as assessed by multivariable analysis (OR 6.13, 95% CI 1.38–27.3; P = 0.017). The recurrence rate was 4.8%; mortality rate of patients was 2.9%. Three-year survival rate after surgery was 73.8%. CONCLUSIONS Surgical treatment of spontaneous pneumothorax may be effective and safe in selected elderly patients. Moreover, higher PaCO2 and poorer performance status were independent risk factors for postoperative persistent air leaks and complications, respectively.

Imaging Evaluation of Modified Poppen Approach for Microsurgical Removal of Pineal Lesions

2020 ◽  
Vol 10 (6) ◽  
pp. 1352-1358
Author(s):  
Chuandong Cheng ◽  
Jinlong Wu ◽  
Xiaoyu Ru ◽  
Ying Ji
Keyword(s):  
Postoperative Complications ◽  
Clinical Data ◽  
Tumor Resection ◽  
Occipital Lobe ◽  
Pineal Region ◽  
Subtotal Resection ◽  
Image Evaluation ◽  
Imaging Evaluation ◽  
Anatomical Relationship

Objective: The pineal region is deep, and anatomical relationship is complex. Imaging evaluation can effectively guide all kind of neurosurgery. The aim of this study was to explore the value of image evaluation in pineal region microsurgery via modified Poppen approach. Methods: From January 2008 to December 2017, the imaging and clinical data form 62 patients received microsurgery of pineal lesions via the modified Poppen approach at our Hospital were reviewed. The incidences of postoperative complications were compared between the patients with differences in lesion diameter, tentorial angle and preoperative hydrocephalus. Result: According to the data from image evaluation, all the pineal lesions was removed through modified Poppen approach, with total tumor resection in 48 cases, subtotal resection in 10 cases, and partial resection in 4 cases. After 3 to 12 months follow-up, the complication was found in 13 cases (21.0%), including hemianopia (2 cases), occipital lobe contusion (7 cases), monoparesis (2 cases), intracranial infection (2 cases). The incidences of postoperative hemianopia and monoparesis for patients with a lesion > 4.5 cm were significantly higher than those with a lesion ≤ 4.5 cm (P < 0.05). The incidence of postoperative hemianopia for the patients with a tentorial angle > 60° was significantly higher than for those with a tentorial angle ≤ 60° (P < 0.05). Conclusion: Imaging evaluation is useful for microsurgical removal and prediction of complication for modified Poppen approach of pineal lesions.

Glioblastoma (GBM) in elderly patients: A randomized phase III trial comparing survival in patients treated with 6-week radiotherapy (RT) versus hypofractionated RT over 2 weeks versus temozolomide single-agent chemotherapy (TMZ).

2010 ◽  
Vol 28 (18_suppl) ◽  
pp. LBA2002-LBA2002 ◽  
Author(s):  
A. Malmstrom ◽  
B. H. Grønberg ◽  
R. Stupp ◽  
C. Marosi ◽  
D. Frappaz ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Survival Data ◽  
Treatment Time ◽  
Performance Status ◽  
Treatment Options ◽  
Single Agent ◽  
Tumor Resection ◽  
Phase Iii ◽  
Primary Study ◽  
Significant Difference

LBA2002 Background: Despite treatment advances, survival of elderly GBM patients (pts) is usually < 12 months. Hypofractionated RT is advocated in order to shorten treatment time, and chemotherapy has been proposed as an alternative to RT. In a randomized trial we compared two different RT schedules with single-agent TMZ chemotherapy. Methods: Newly diagnosed GBM pts age ≥ 60 years with PS 0-2, were randomized to either standard RT (60 Gy in 2 Gy fractions over 6 weeks) or hypofractionated RT (34 Gy in 3,4 Gy fractions over 2 weeks) or 6 cycles of chemotherapy with TMZ (200 mg/m2 day 1-5 every 28 days). Follow-up including quality of life, symptom checklist, and steroid dosing was completed at 6 weeks, 3 months, and 6 months after start of treatment. The primary study end point was overall survival (OS). Results: A total of 342 pts were included. 291 pts were randomized between the 3 treatment options, 51 pts between hypofractionated RT and TMZ. Median age was 70 years (range 60-88), 59% were male and 72% had undergone tumor resection, the remaining 28% had a diagnostic biopsy only. Performance status was 0-1 for 75% of pts. Survival data are available for 334 pts (98%), with 11 pts (3%) being alive. There was no significant difference in OS between the three treatment arms, with median survival being 8 months for TMZ, 7.5 months for hypofractionated RT and 6 months for 6 weeks RT (p=0.14). Conclusions: Elderly patients with GBM have a short survival. Time-consuming therapy that does not offer longer survival should therefore be avoided. Our study showed no advantage of standard 6 weeks RT compared to hypofractionated RT over 2 weeks or 6 cycles of TMZ chemotherapy. These results indicate that standard RT should no longer be offered to the elderly pt population with GBM. Exclusive TMZ chemotherapy may be an alternative to RT. Subgroup analyses and determination of molecular markers is ongoing. Whether outcome could be improved by concomitant chemoradiotherapy is subject of ongoing clinical trials. [Table: see text]

scholarly journals Incidence and clinical profiles of COVID-19 in patients with gynecological surgery: A single center descriptive study from Spain.

2020 ◽  
Author(s):  
Reyes Oliver ◽  
Gregorio Lopez-Gonzalez ◽  
Alberto Galindo ◽  
Carmen Alvarez-Conejo ◽  
Sofia Aragon-Sanchez ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
False Negative ◽  
False Negative Rate ◽  
Second Phase ◽  
Gynecological Surgery ◽  
Rt Pcr ◽  
Third Phase ◽  
Surgical Complexity ◽  
Clinical Records

Abstract Background: The inflammatory reaction after a surgical intervention could exacerbate the course of the COVID-19. We aim to determine the rate of COVID-19 and its complications among gynecological surgeries in the context of different measures taken during the pandemic period in our department. Methods: A retrospective longitudinal observational study was conducted. Clinical records of patients who underwent gynecological surgery from March 1 st to April 10 th , 2020 were reviewed. During this period, three different approachs were made: first phase, without any screening or surgical restrictions; second phase, with presurgical epidemiological screening using a specific questionnaire; and third phase, also with presurgical SARS-COV-19 RT-PCR. During the second and third phases the surgical activity and complexity were restricted, and different workflows were established for patient with suspected/confirmed infection. After hospital discharge, telephone follow-up was performed and screening for COVID-19 was carried out. Complications from the disease were analyzed. Results : Of the 118 patients that underwent gynecological surgeries, 10 (8.5%) were perioperatively diagnosed with COVID-19. Of these patients, 8 (80%) were not pre-surgical screened for SARS-CoV-2 infection, neither clinical nor with RT-PCR. The other 2 (20%) were preoperative screened with RT-PCR, one of them with a positive test result. Screening false negative rate was 0.8%. No postoperative complications derived from COVID-19 were observed. Conclusions: The establishment of different surgical workflows, the reduction of surgical complexity, and the use of a pre-surgical screening to detect patient at SARS-CoV-2 infection risk, could reduce the postoperative complications derived from that infection and improve surgical outcomes.

Comprehensive geriatric assessment (CGA) in elderly women with early breast cancer

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 19641-19641
Author(s):  
R. S. Girones ◽  
D. M. Torregrosa ◽  
J. Torró ◽  
J. Aguiló ◽  
I. Maestu ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Elderly Patients ◽  
Early Breast Cancer ◽  
Functional Impairment ◽  
Performance Status ◽  
Geriatric Syndrome ◽  
Charlson Score ◽  
Co Morbidity ◽  
High Prevalence

19641 Background: Advancing age is a major risk factor for breast cancer. Long-term follow up is recommended after diagnosis and treatment of early breast cancer. With older age, the risk of comorbid conditions and functional impairment is increased. A useful tool in the management and follow-up of these elderly patients could be a CGA Methods: Purpose of the study: Descriptive, transversal study of the prevalence of other comorbidities and of the functional impairment in elderly patients on follow-up after curative treatment of early breast cancer. Patients: Women aged ≥ 70 years at time of diagnosis, with removed early breast cancer. Attended in a outpatient unit from January 2005 to June 2006. No disease recurrences were allowed. Methods: CGA was conducted in an oncology unit. The assessment used usual screening instruments (ADL, IADL, POMA, GDS, MMSE, MNA) as well as the performance status (PS). Co-morbidity was classified using the Charlson score. Results: 91 pts underwent CGA. Mean age at surgery of primary tumour: 76 (70–92). Mean age at time of CGA: 80 (71–95). > 75% of patients had more than 84 years at time of GCA: Median follow up: 5 years (1–12). 47% PS 0. 9% PS 2. 83% were fully independent for ADL and 71% for IADL. IADL most affected was the ability to drive/use public transport. Median Charlson Score was 2 (1–6). ≥ 75% of patients had score ≥4. Most frequent comorbidity: cardiovascular disease (hypertension). Cognitive deterioration: 15%, depression: 16%. Only 28% were thin (BMI< 22). 75% were polymedicated (> 6 drugs). 28% had geriatric syndromes. 23% were “frail” (at least one of the following items): ADL < 80; ≥ 3 comorbidities, performance status < 60, ≥ 1 geriatric syndrome. Conclusions: Our results are better than reports from other geriatric teams using CGA, in terms on functional status and frailty. A high prevalence of comorbidity in our study, similar to other reports. A selection bias cannot be excluded, as the fitter patients are those that usually keep on with the follow-up. While those frail patients that do not due to their functional impairment are usually lost. Older patients with early breast cancer on follow-up have a high prevalence of comorbidity. However, in our serie, function and independence is maintained. No significant financial relationships to disclose.

Exclusive chemoradiotherapy without TURBT for frail and elderly patients with an invasive bladder cancer: Which platin fits better?

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 279-279 ◽  
Author(s):  
C. Khoury ◽  
E. Martin ◽  
M. Gauthier ◽  
G. Crehange ◽  
S. Ladoire ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Performance Status ◽  
Progression Free Survival ◽  
Late Toxicity ◽  
Diagnostic Purpose ◽  
Median Dose ◽  
Curative Intent ◽  
Free Survival ◽  
Median Total Dose

279 Background: Frail and elderly patients (pts) with invasive bladder carcinoma (BC) are often unfit for surgery. Whether exclusive concomitant chemoradiotherapy (cCRT) without TURBT could be performed in a curative-intent remains uncertain. Methods: From 1996 to 2007, 68 pts were treated with exclusive cCRT. Median age was 77.5 years (70-91). WHO performance status (PS) at baseline were: PS 0: 27 pts; PS 1: 36 pts; PS 2; 4 pts; PS 3: 1 pt. 31 pts (45.5%) had a Charlson's score ≥ 5. Tumors were staged T1 (5 pts), T2 (44 pts), T3 (13 pts) and T4 (6 pts). 87.5% of the pts were clinically staged N0. Transuretral resection bladder tumor (TURBT) was incomplete and thus done for a diagnostic purpose only. 58 pts had an urothelial tumor (85.29%). External radiotherapy (ERT) was delivered with 1.8-2.0 daily fractions: median total dose of 63Gy [18Gy-69.4Gy] to the bladder and 92% of the pts had a whole pelvic ERT: median dose: 37.2Gy [18Gy-46Gy]. Drug was either cisplatin (CDDP) for 40 pts or carboplatin (CBDCA) for 28 pts. Overall survival (OS) and progression-free survival (PFS) rates were evaluated. Results: The rate of compliant pts with the full course of cCRT was 77.9% (53 pts). 5 pts stopped cCRT for acute urinary adverse events (AE) whereas 8 pts stopped chemotherapy only for hematological or renal biochemical AE. For late toxicity, 5 pts had a G3/4 toxicity (1 rectal bleeding, 1 urinary bleeding, 1 recto-urinary fistula, 1 urinary incontinence and 1 urinary retention). Median follow-up was 4.6 years [CI95%: 3.43-5.93]. Of the 68 pts, 14 are alive (13 recurrence-free) amongst the 61 evaluable pts and 47 have died (24 recurrence-free). OS rates at 2 and 5 years were 50% (CI95%: [37.45%-61.44%]) and 31% (CI95%: [13.67%-38.43%]). PFS rates at 2 and 5 years were 37.4% [CI95%: 25.89%-48.82%] and 22% [CI95%: 12.25%- 33.61%], respectively. OS and PFS rates were worse for pts treated with CBDCA in comparison with those treated with CDDP (p= 0.01 for OS and p= 0.03 for PFS). Combined 5-FU did not impact either OS or PFS. Conclusions: cCRT for elderly pts with a BC was feasible. For selected pts with a good PS, the adequate drug that should be combined with a conventional full course of ERT remains CDDP. No significant financial relationships to disclose.

Erlotinib (E) in non small cell lung cancer (NSCLC) patients (pts) ≥75 years old with comorbidities (cM): Experience at a tertiary referral center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19111-e19111
Author(s):  
Konstantinos N. Syrigos ◽  
Evangelos Sarris ◽  
Alexios S Strimpakos
Keyword(s):  
Side Effects ◽  
Disease Control ◽  
Performance Status ◽  
Egfr Mutations ◽  
Time To Progression ◽  
Duration Of Treatment ◽  
Tertiary Referral Center ◽  
Best Response ◽  
Nsclc Patients

e19111 Background: Besides chemotherapy, E is another option in NSCLC pts especially in those with EGFR mutations. Elderly pts enrolled in trials are fit without cM, but in clinical practice most suffer from cM. Methods: Medical records of 1221 pts diagnosed with NSCLC between 2008-2012 were screened. We examined pts ≥75 yrs for demographics, clinical data and Tx details. Results: 233/1221 NSCLC pts received E at any line. 53/233 (23%) were ≥75 yrs old. Male:female ratio was 34:19 and median age 79 yrs (range 75-88). NSCLC subtypes included 31 adenoca, 8 squamous cell, 9 NOS and 5 others. 50/53 pts had cM (≥2 in 46 pts, 1 in 4pt). Main cM were cardiovascular disease (n=41), COPD (n=14), other cancer (n=10) and diabetes (n=8). 8 pts were tested for EGFR mutations (5 -ve, 3 +ve). Performance Status was satisfactory (ECOG 0-1) in 8 pts and poor (2-3) in 45pts. 8pts were treated with E 100mg and 45 pts with E 150mg (12 pts needed dose reduction). Complete follow up data were found in 46pts. Mean duration of treatment was 79 days (range 9-662). 35/46 pts experienced side effects (s.e) [rash n=29, diarrhea n=17] which led to treatment discontinuation in 12pts. Pts with abnormal creatinine clearance (n=13) were more likely to stop treatment due to s.e (6/13 versus 6/33). 17/46 pts (37%) achieved disease control (5 PR, 12 SD) and a time to progression (TTP) of 157 days (range 106-662, 95% CI 132.79-270,74) while 22/46 pts had PD as best response (TTP 49d, range 19-88, CI 44,67-64,97). 7pts were not evaluable (stopped Tx due to s.e). All EGFR+ve pts had disease control (2PR, 1SD). Conclusions: E is a valuable option in elderly NSCLC patients with co-morbidities, especially if they harbor EGFR mutations. Impaired renal function might be associated with propensity to side effects and early Tx discontinuation.

Bevacizumab (Bv) in non small cell lung cancer (NSCLC) patients ≥75 years old with pre-existing cardiovascular disease (CVD): Experience at a tertiary referral center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e19087-e19087
Author(s):  
Alexios S Strimpakos ◽  
Demetrios Vassos ◽  
Meropi Panagiotarakou ◽  
Konstantinos N. Syrigos
Keyword(s):  
Cardiovascular Disease ◽  
Medical Records ◽  
Performance Status ◽  
Median Number ◽  
Tertiary Referral ◽  
Tertiary Referral Center ◽  
History Of ◽  
Fatal Adverse Events ◽  
Nsclc Patients

e19087 Background: Bv is a novel anti-angiogenic agent used in many advanced solid tumours, including non-squamous NSCLC. In contrast to clinical studies where enrolled pts are fit, many elderly NSCLC pts suffer from co-morbidities and often have history of a CVD. Methods: Medical records of 2,672 pts diagnosed with NSCLC between 2001-2012 were screened. We identified and examined pts ≥75 yrs old treated with Bv, for their demographics, clinical data and treatment (Tx) details. We focused on those elderly pts with stable pre-existing cardiovascular disease. Results: 356/2672 NSCLC pts received Bv at any Tx line. 33/356 (9.2%) were ≥75 yrs old. Of those, 29 had various co-morbidities including 19 pts with stable CVD on medical Tx. In the 19 pts with CVD the male:female ratio was 17:2 and median age 76 yrs (range 75-86). 8/19 pts had impaired renal function. All pts were of Performance Status ECOG 0/1. Median number of Bv cycles was 5 (range 2-11). 17/19 pts experienced ≥1 side effects (11 epistaxis and haemoptysis, 5 proteinuria, 4 hypertension) which led to treatment discontinuation in 5 pts. No major/fatal adverse events were noted. 8/19 pts (42%) showed radiological partial response and 5 (19%) stable disease (total disease control rate 61%). Median survival from initiation of Bv till death/last follow up was 7 months (range 2-28, 95% CI 5.14-12.55). Conclusions: Treatment with Bevacizumab seems to be safe and effective in elderly NSCLC patients with controlled pre-existing cardiovascular disease and good PS. These patients might benefit from participation in clinical trials similarly to younger NSCLC patients.

Risk factors for venous thromboembolism in elderly patients with glioblastoma.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e13031-e13031
Author(s):  
Neda Hashemi-Sadraei ◽  
Roozbeh Sharif ◽  
Jorge Machicado ◽  
Saurabh Dahiya ◽  
Manmeet Singh Ahluwalia
Keyword(s):  
Risk Factors ◽  
Venous Thromboembolism ◽  
Elderly Patients ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Multivariable Analysis ◽  
Tumor Resection ◽  
Cleveland Clinic ◽  
The Elderly ◽  
Categorical Variables

e13031 Background: Venous thromboembolism (VTE) is a common complication in glioblastoma (GBM) patients. Physicians are reluctant to administer anticoagulants to GBM patients with VTE, particularly to the elderly patients. Methods: After obtaining IRB approval, the Cleveland Clinic Brain Tumor and Neuro-Oncology Center’s database was used to identify patients with histologically confirmed GBM who were diagnosed with VTE and were ≥65 years of age at the time of diagnosis of GBM. Bivariate comparison of demographic and clinical features was performed by occurrence of DVT, using t-test for continuous data and fishers exact test for categorical variables. Multivariate proportional hazard model was developed adjusting for number of comorbidities (none, 1, 2-3, >3), Karnofsky Performance Status (KPS) at presentation (>70, ≤70), age (>75, ≤75), race, treatment (chemotherapy, radiation therapy, tumor resection). All p-values were 2-sided and were considered significant when <0.005. Results: Chart records of 517 patients diagnosed between 1990 and 2010 were included for analysis. Among 517 cases, 99 patients (54% male, median age at presentation 72 years, range 65-92 years) developed VTE. Median follow-up was 6.58 ± 9.58 months. Eighty-nine (90.8%) cases were diagnosed within 3 months of craniotomy. On univariable analysis, risk factors for VTE included lower KPS (HR 0.98, CI 0.96– 0.99, p = 0.001), thalamic tumors (HR 3.11, CI 1.14– 8.50, p = 0.027), and lower extremity paresis (HR 2.24, CI 1.46-3.46, p < 0.0001). Caucasian patients had a lower trend for developing VTE, however this was not statistically significant. On multivariable analysis, lower KPS was found to be related with higher incidence of VTE (HR 0.35, CI 0.18 – 0.66, p = 0.001). Conclusions: Lower KPS is associated with higher incidence of VTE. Further studies are needed to determine risk stratification and whether the use of medical prophylaxis after neurosurgical intervention can lead to decrease in the rates of VTE in elderly GBM patients.

scholarly journals Patient-Specific Implants for Pelvic Tumor Resections

2021 ◽  
Vol 11 (8) ◽  
pp. 683
Author(s):  
Kevin Döring ◽  
Kevin Staats ◽  
Stephan Puchner ◽  
Reinhard Windhager
Keyword(s):  
Postoperative Complications ◽  
Median Number ◽  
Harris Hip Score ◽  
Patient Specific ◽  
Limb Salvage Surgery ◽  
Patient Specific Implants ◽  
Custom Made ◽  
Revision Reconstruction ◽  
One Year

Introduction Limb salvage surgery for periacetabular malignancies is technically demanding and associated with a considerable likelihood of postoperative complications and surgical revision. Reconstruction using custom-made implants represents the treatment of choice. This study was conducted to analyze treatment outcomes of custom-made implants in a single orthopaedic tumor center. Patients and Methods Twenty patients with a histologically verified periacetabular malignancy and a median follow up time of 5 (1–17) years were included. Results The median number of revision surgeries per patient was 1.5 (0–7). Complications were dislocations in 3 patients, aseptic loosening in 4 patients, deep infections in 9 patients, thromboembolic events in 5 patients and sciatic nerve lesions in 4 patients. Overall survival was 77% after one year, 69% after two years and 46% after five years. Median Harris Hip Score was 81 (37–92) points at last follow up. Conclusion Although internal hemipelvectomy and reconstruction using custom-made implants is linked with a high risk of postoperative complications, good functional outcomes can be regularly achieved. This information may help treating surgeons to find adequate indications, as eligible patients need to be critically selected and integrated into the decision-making process.

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