Disease- and recurrence-free survival after surgical resection of solitary bone metastases of the pelvis

For patients with advanced cancer who present with or develop a bone lesion as the only focus of cancer beyond the primary site, en bloc resection of the metastasis may optimize local tumor control, provide durable pain relief, and possibly prolong patient survival. For patients with pelvic metastasis, however, this surgery can be associated with a high risk of complications. We analyzed fourteen consecutive patients with a solitary metastasis to the bony pelvis who underwent en bloc resection to determine if the benefits of surgery outweigh the surgical morbidity. The epicenter of the tumor was isolated to the ilium (four patients), the pubis (one patient), and the ischium (three patients), or to the periacetabular region (six patients). Surgical margins were negative for tumor in 13 of 14 patients. No local recurrence developed at last follow-up for six survivors (median 74.5 months) and eight non-survivors (median 53 months). Local pain relief was achieved in all patients. For patients with a solitary pelvic metastasis, the favorable median patient survival justifies consideration of a radical surgical approach to achieve pain palliation and tumor control.