3D-printed hemipelvic endoprosthesis is an emerging solution for personalized limb-salvage reconstruction after periacetabular tumor resection. Further clinical studies are still required to report its surgical characteristics, outcomes, benefits and drawbacks. Sixteen consecutive patients underwent periacetabular tumor wide resection and pelvic reconstruction with a 3D-printed hemipelvic endoprosthesis from 2018 to 2021. The surgical characteristics and outcomes are described. The mean follow-up duration was 17.75 months (range, 6 to 46 months). Five patients underwent surgery for type I + II resection and reconstruction, seven for type II + III resection and reconstruction, three for type II resection and reconstruction, and one for type I + II + IV resection and reconstruction. The incidence of postoperative complication was 12.5% (2/16) for deep venous thrombosis (DVT), 12.5% (2/16) for pneumonia, and 12.5% (2/16) for would deep or superficial infection. During follow-up, two patients (12.5%) suffered hip dislocation and underwent revision surgery. CT demonstrated an obvious prosthetic porous structure–bone fusion after follow-up of at least 6 months. At the final follow-up, 12 lived with no evidence of disease while four lived with disease; no patients experienced pain; and 15 had independent ambulation, with a mean Musculoskeletal Tumor Society (MSTS) score of 85.8% (range, 26.7% to 100%). 3D-printed hemipelvic endoprosthesis facilitates wide resection of periacetabular tumor and limb-salvage reconstruction, thus resulting in good oncological and functional outcomes. The custom-made nature is able to well mimic the skeletal anatomy and microstructure and promote osseointegration. Perioperative complications and rehabilitation exercise still need to be stressed for this engineering technology-assisted major orthopedic surgery.

Background Synchronous bone metastases (BM) have a notable impact on the survival rates of patients across various cancer types. While primary tumor surgery (PTS) has shown potential benefits, its impact across different cancers and patient subgroups needs further clarification. This study aimed to investigate the survival benefits of PTS across various cancer types. Methods This retrospective cohort study analyzed data from the Surveillance, Epidemiology, and End Results (SEER) database, covering 53,015 patients diagnosed with BM from 2010 to 2019. Propensity score matching (PSM) was performed to reduce baseline imbalance. Overall survival (OS) and cancer-specific survival (CSS) were evaluated using Kaplan–Meier analysis and Cox proportional hazards regression. Results PTS substantially improved overall and cancer-specific survival in patients with lung, kidney, breast and bladder cancers. All surgical modalities benefited breast and renal cancer survival. In prostate cancer, PTS produced no overall survival gain; survival varied by surgery type, being better after prostatectomy and worse with local resection. For liver cancer, PTS improved cancer-specific but not overall survival, and the small matched cohort necessitates circumspect interpretation. Conclusion The findings indicate that PTS can significantly enhance survival in selected patients with BM, particularly in lung, kidney, breast, and bladder cancers. Tailoring surgical approaches based on individual cancer type and patient characteristics is crucial to optimizing treatment outcomes. Further studies are required to validate these results and expand the understanding of PTS in cancer management.

Treatment options for recurrent osteosarcoma remain limited, and prognosis is poor. Pazopanib, a multi-targeted tyrosine kinase inhibitor, has shown activity in various sarcomas. This study evaluated the efficacy and safety of pazopanib combined with doxorubicin and cisplatin (Paz + AP regimen) in patients with recurrent osteosarcoma and analyzed its impact on survival. This single-center retrospective cohort study included recurrent osteosarcoma patients treated between February 2022 and February 2023. Propensity score matching was used to balance baseline characteristics. A total of 100 patients were analyzed: 50 received the Paz + AP regimen, and 50 received conventional chemotherapy (AP regimen). Treatment efficacy was assessed using response evaluation criteria in solid tumors (RECIST 1.1) criteria. The primary endpoint was progression-free survival (PFS); secondary endpoints included overall survival (OS), objective response rate, disease control rate, safety, and treatment compliance. Baseline characteristics were well balanced between groups ( P > .05). The Paz + AP group achieved a higher disease control rate than the control group (62.0% vs 42.0%, P = .046), whereas the difference in objective response rate was not significant (26.0% vs 14.0%, P = .13). Median PFS was significantly longer in the Paz + AP group than in controls (5.1 vs 2.2 months, P = .04). Although the median OS was slightly shorter in the Paz + AP group (8.0 vs 9.6 months), its survival curve declined more slowly after 12 months, showing a significant difference ( P = .03). The incidence of adverse events was comparable (92.0% vs 88.0%), though hypertension (28.0% vs 10.0%, P = .03) and hand-foot syndrome (22.0% vs 4.0%, P = .01) were more frequent with pazopanib. No differences were observed in grade ≥3 or serious adverse events. Subgroup analysis indicated greater PFS benefits among patients with lung metastasis, recurrence interval ≥6 months, Eastern Cooperative Oncology Group (ECOG 0–1), and those receiving full-dose pazopanib. The Paz + AP regimen significantly prolonged PFS and improved disease control in recurrent osteosarcoma, with manageable toxicity and good compliance. Although OS improvement was limited, the regimen showed potential clinical value, particularly for patients with favorable performance status and longer recurrence intervals. Prospective studies are warranted to confirm these findings.