Patient-specific guides for consistently achieving R0 bone margins after resection of primary malignant bone tumors of the pelvis

Autor: Xavier du Cluzel de Remaurin, Valerie Dumaine, Victoire Cladiere-Nassif, Philippe Anract, David Biau
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: World Journal of Surgical Oncology, Vol 22, Iss 1, Pp 1-9 (2024)
Druh dokumentu: article
ISSN: 1477-7819
DOI: 10.1186/s12957-024-03478-3
Popis: Abstract Aims Primary malignant bone tumor of the pelvis is an uncommon lesion, the resection of which via freehand osteotomy is subject to inaccuracy due to its three-dimensional anatomy. Patient-Specific Guides (PSG), also called Patient-Specific Instruments (PSI) are essential to ensure surgical planning and resection adequacy. Our aim was to assess their use and effectiveness. Methods A monocentric retrospective study was conducted on 42 adult patients who underwent PSG-based resection of a primary malignant bone tumor of the pelvis. The primary outcome was the proportion of R0 bone margins. The secondary outcomes were the proportion of overall R0 margins, considering soft-tissue resection, the cumulative incidence of local recurrence, and the time of production for the guides. A comparison to a previous series at our institution was performed regarding histological margins. Results Using PSGs, 100% R0 safe bone margin was achieved, and 88% overall R0 margin due to soft-tissue resection being contaminated, while the comparison to the previous series showed only 80% of R0 safe bone margin. The cumulative incidences of local recurrence were 10% (95% CI: 4–20%) at one year, 15% (95% CI: 6–27%) at two years, and 19% (95% CI: 8–33%) at five years. The median overall duration of the fabrication process of the guide was 35 days (Q1–Q3: 26–47) from the first contact to the surgery date. Conclusions Patient-Specific Guides can provide a reproducible safe bony margin.
Databáze: Directory of Open Access Journals
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