What is a hemipelvectomy?
August 18, 2025
Medically Reviewed | Last reviewed by on August 18, 2025
The pelvis is a set of bones in the lower torso that connects the spine to the legs. It starts out connected by cartilage when we¡¯re young but fuses together at maturity. As a structure, it serves three main functions:
- Protecting the organs inside the pelvic cavity
- Serving as an anchor point for the muscles controlling the lower body
- Providing an axis for weight distribution of the upper body
Sometimes, part of the pelvis must be removed surgically in order to successfully treat cancer. This type of surgery is known as a hemipelvectomy.
Types of hemipelvectomy
In 1978, Drs. Enneking and Dunham developed a classification system for pelvic resection based on the location and extent of bone removal for tumors. It divides the pelvis into four main regions:
- The ilium: This is the wing-like section that forms the crest of each hip bone.
- The periacetabular region: This is the cup-shaped cavity that cradles the head of the femur in the hip socket.
- The obturator (pubis): This is the small, oval-shaped opening at the bottom of the pelvis where muscles and nerves pass through.
- The sacrum: This is the lowest part of the spine.
Physicians use this classification system when discussing hemipelvectomies amongst themselves so that they know exactly what is involved. But hemipelvectomies can also be classified as internal or external. An internal hemipelvectomy is a limb-salvaging procedure while an external hemipelvectomy is akin to a hindquarter amputation.
Determining what kind of hemipelvectomy you need
Which type of hemipelvectomy you need depends on the location and stage of your cancer. There are three critical structures in the pelvis that enable your leg to function properly:
- the lumbo-sacral plexus (sciatic nerve)
- the hip joint capsule
- the anterior blood vessels and nerves
If cancer has compromised any two of those structures, then an amputation should be performed. Otherwise, your leg will just be this painful, heavy, useless thing you drag around with you.
Key takeaways
- A hemipelvectomy is the surgical removal of part of the pelvis.
- Which type of hemipelvectomy you need depends on the location and stage of your cancer.
- Hemipelvectomy patients can still walk after surgery -- many without assistance.
A hemipelvectomy can be used to manage a wide variety of cancers
A hemipelvectomy is a surgery that can be adapted to almost any cancer diagnosis. It is used most frequently with common pelvic sarcomas: chondrosarcoma, osteosarcoma and Ewing¡¯s sarcoma. But the procedure can also be used to treat other types of cancer that have spread to the bones in the pelvis.
Ideally, we¡¯d prefer not to perform a hemipelvectomy if a patient has metastatic cancer. But even if they do, that doesn¡¯t necessarily mean we wouldn¡¯t perform one. However, the recovery period after a hemipelvectomy is long. So, in patients with metastatic disease, if there is another treatment option available, we will explore that first.
The risks and benefits of a hemipelvectomy
As with any surgical procedure, there are several risks involved with a hemipelvectomy. The risks it shares with virtually all other surgeries include:
- bleeding
- infection
- damage to blood vessels and nerves
- swelling
- pain
- the need for additional surgery
Those more specific to hemipelvectomies include damage to the bowel or bladder and sexual dysfunction. But life expectancy after a hemipelvectomy depends entirely on the stage of the disease, not the surgery.
What to look for if you need a hemipelvectomy
If you¡¯ve been told that you need a hemipelvectomy, it is critically important to get yours done at an institution that does these procedures often ¡ª not just once or twice a year. Here at MD Anderson, our surgeons perform about 60 hemipelvectomies a year.
That kind of expertise is going to give you a better outcome. But MD Anderson is also unique in that we established the Pelvic Sarcoma Center of Excellence in 2011. We also take a multidisciplinary approach to cancer care. That means orthopedic oncologists, surgical oncologists, plastic surgeons, vascular surgeons, urologists, anesthesiologists, gynecologists, psychiatrists, and physical and occupational therapists all work together ¡ª before, during and after the surgery ¡ª to give you the best possible result.
Pelvic sarcomas tend to have a worse prognosis than other sarcomas. But our team approach means we can be more aggressive when treating them. We have surgeons who can address any location the tumor can touch.
All of our hemipelvectomy patients eventually walk, too ¡ª most without assistance. Some even get back to activities like mountain climbing, snowboarding and jogging. Patients can lead active, successful lives, even after a hemipelvectomy.
, is the chair of Orthopedic Oncology. She specializes in the treatment of pediatric sarcoma and pelvic sarcoma surgery.
or call 1-877-632-6789.
Patients can lead active, successful lives after a hemipelvectomy.
Valerae Lewis, M.D.
Physician