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Details

Authors
Supervisors
Banse, Xavier
 ;
Delloye, Christian
Abstract
(en) The most common primary bone sarcomas are Ewing sarcoma and osteosarcoma in children and adolescents, and chondrosarcoma in elderly patients. Approximately 25% of Ewing sarcomas, 18% of chondrosarcomas, and 10% of osteosarcomas are located in the pelvis. Relative to surgical treatment of tumours in the extremities, resection and reconstruction of pelvic sarcomas remains challenging, with higher rates of local recurrence and complications. Furthermore, lower functional outcomes are observed after pelvic tumour resection than after surgery elsewhere. The main objectives of this thesis were to improve accuracy at several steps of pelvic sarcoma resection and reconstruction. Resection of pelvic sarcomas was improved using tools that increase surgical accuracy with more accurate tumour delineation, preoperative planning, and plane resection with navigation. Reconstruction was improved for optimization of allograft fit using registration for allograft selection, transfer of resection planes from the patient to the graft, and the use of navigation for allograft cutting. Finally, postoperative evaluation of surgical accuracy was improved by accurate analysis of tumourous specimens by magnetic resonance imaging, and identification of the ambiguous areas. Though this work contributed to improving the accuracy of pelvic sarcoma surgery, additional improvements are possible, such as with the use of a surgical robot. New imaging modalities that could better distinguish tumour tissue from peritumourous oedema are needed. We hope that new technologies will continue to become available for improving the accuracy of the difficult task of pelvic tumour resection.
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Docquier, P.-L. (2010). Imaging and navigation improve accuracy in bone tumour surgery. https://hdl.handle.net/2078.5/130917