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

Xavier du Cluzel de Remaurin, Valerie Dumaine, Victoire Cladiere-Nassif, Philippe Anract, David Biau

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Article in World journal of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 authors.

Xavier du Cluzel de RemaurinOrthopaedic and Traumatology Department, Cochin Hospital, Paris Cité University, 27, rue du Faubourg-Saint-Jacques, Paris, 75014, France. xavier.ducluzel@aphp.fr.

Valerie DumaineOrthopaedic and Traumatology Department, Cochin Hospital, Paris Cité University, 27, rue du Faubourg-Saint-Jacques, Paris, 75014, France.

Victoire Cladiere-NassifOrthopaedic and Traumatology Department, Cochin Hospital, Paris Cité University, 27, rue du Faubourg-Saint-Jacques, Paris, 75014, France.

Philippe AnractOrthopaedic and Traumatology Department, Cochin Hospital, Paris Cité University, 27, rue du Faubourg-Saint-Jacques, Paris, 75014, France.

David BiauOrthopaedic and Traumatology Department, Cochin Hospital, Paris Cité University, 27, rue du Faubourg-Saint-Jacques, Paris, 75014, France.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

aimsPrimary 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.

methodsA 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.

resultsUsing 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.

conclusionsPatient-Specific Guides can provide a reproducible safe bony margin.

Indexed as

Bone NeoplasmsMargins of ExcisionNeoplasm Recurrence, LocalAdolescentAdultAgedFemaleFollow-Up StudiesHumansMaleMiddle AgedOsteotomyPelvic BonesPelvic NeoplasmsPrognosisRetrospective Studies3D printingPatient-specific instrumentPelvisPrimary malignant bone tumor

Identifiers

PMID39232698

DOI10.1186/s12957-024-03478-3

PMCPMC11375823

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LicenceCC BY-NC-ND

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