ArticleInternational orthopaedics2026
Automated dangerous region generation for computer-assisted pelvic bone tumour resection: a retrospective comparative study.
Article in International orthopaedics, 2026. 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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Abstract
backgroundComputer-assisted navigation improves spatial orientation during pelvic bone tumour resection but provides no direct three-dimensional feedback regarding the distance between the tumour and planned osteotomy planes. This study evaluated the clinical value of automated dangerous region generation (ADRG) as an adjunct to computer-assisted surgery.
methodsWe retrospectively analyzed 32 patients with pelvic bone tumours treated between May 2018 and February 2025. Sixteen underwent resection using automated dangerous region generation combined with computer-assisted surgery (ADRG + CAS group), and 16 underwent computer-assisted surgery alone (CAS-only group). Perioperative, oncological, survival, and functional outcomes were compared.
resultsMedian operative time was shorter in the ADRG + CAS group than in the CAS-only group [212.5 min (161.3-325.0) vs 355.0 min (267.8-405.0); p = 0.013]. Median intraoperative blood loss was also lower [1,100 mL (850-1,475) vs 1,550 mL (1,050-2,750); p = 0.040]. Length of stay did not differ significantly [18.0 days (16.0-29.8) vs 17.0 days (14.3-22.0); p = 0.161]. Local recurrence occurred in no patient in the ADRG + CAS group and in three patients in the CAS-only group. Metastasis occurred in two and three patients, respectively, and two patients in each group died. Wide surgical margins were obtained in 14/16 (87.5%) patients in the ADRG + CAS group versus 12/16 (75.0%) in the CAS-only group, while marginal surgical margins were obtained in 2/16 (12.5%) versus 4/16 (25.0%), respectively; no intralesional margins were recorded (p = 0.654). The estimated two year overall survival (OS) rate was 93.8% (95% CI, 63.3%-99.1%) in both groups (log-rank p = 0.986). The estimated two year progression-free survival (PFS) rates were 87.5% (95% CI, 58.6%-96.7%) in the ADRG + CAS group and 81.3% (95% CI, 52.5%-93.6%) in the CAS-only group (log-rank p = 0.633). Functional outcomes were comparable (p = 0.157).
conclusionsIn this retrospective cohort, the ADRG + CAS group had a shorter operative time and lower intraoperative blood loss than the CAS-only group, and wide surgical margins were achieved in most patients receiving ADRG + CAS. ADRG may be a useful adjunct to CAS for surgical margin planning in complex pelvic bone tumour resection.
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