Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Aug;35(8):1209-13.
doi: 10.1007/s00264-010-1127-0. Epub 2010 Sep 23.

Surgical therapy of skeletal complications in multiple myeloma

Sandra Utzschneider  1 , Henning Schmidt, Patrick Weber, Gerwin P Schmidt, Volkmar Jansson, Hans Roland Dürr
Affiliations

Surgical therapy of skeletal complications in multiple myeloma

Sandra Utzschneider et al. Int Orthop. 2011 Aug.

Abstract

Patients with multiple myeloma are often treated surgically as though they have bone metastases. Due to major differences in oncological therapy and comparatively long survival times these patients should be considered separately. Seventy-five multiple myeloma patients were treated surgically (83 interventions) for skeletal complications of the disease. Location and dissemination, symptoms, method of surgery, complications, recurrence and survival time were evaluated retrospectively. Most of the lesions were in the axial skeleton or the proximal extremities apart from one distal lesion of the fibula, and most surgery was performed in the spine (35 patients). The mean follow-up of patients was 5.4 years (range 1-25 years). Survival proved to be very favourable (37% at five years). Patients with a single bone lesion, a negative bone marrow biopsy, no paraproteinaemia in serum or a Salmon-Durie-stage I had a better survival probability. Surgical treatment in patients with multiple myeloma was mostly limited to a palliative approach but survival time was better (37% at five years) than in patients with metastatic bone disease which has to be considered in their surgical treatment.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
Age distribution of 75 patients surgically treated for skeletal lesions of multiple myeloma
Fig. 2
Fig. 2
a, b Large lesion of the pelvis secondary to multiple myeloma, preoperatively treated with chemo- and radiation therapy to eliminate the soft tissue tumour at the time of surgery. c Stabilisation of the bone lesion through cementation
Fig. 3
Fig. 3
Survival probability after surgical therapy of 75 patients with a bone lesion secondary to multiple myeloma
Fig. 4
Fig. 4
Duration of symptoms of 75 patients surgically treated for bone lesions secondary to multiple myeloma (p = 0.053)
Fig. 5
Fig. 5
Survival of the patients depending on a pre- or postoperative radiation (n = 66)
See this image and copyright information in PMC

References

    1. Mundy GR, Bertolini DR. Bone destruction and hypercalcemia in plasma cell myeloma. Semin Oncol. 1986;13:291–299. - PubMed
    1. Kyle RA. Multiple myeloma: review of 869 cases. Mayo Clin Proc. 1975;50:29–40. - PubMed
    1. Bataille R, Sany J. Solitary myeloma: clinical and prognostic features of a review of 114 cases. Cancer. 1981;48:845–851. doi: 10.1002/1097-0142(19810801)48:3<845::AID-CNCR2820480330>3.0.CO;2-E. - DOI - PubMed
    1. Chak LY, Cox RS, Bostwick DG, Hoppe RT. Solitary plasmacytoma of bone: treatment, progression, and survival. J Clin Oncol. 1987;5:1811–1815. - PubMed
    1. Zahlten-Hinguranage A, Goldschmidt H, Cremer FW, Egerer G, Moehler T, Witte D, et al. Preoperative elevation of serum C-reactive protein is predictive for prognosis in myeloma bone disease after surgery. Br J Cancer. 2006;95:782–787. doi: 10.1038/sj.bjc.6603329. - DOI - PMC - PubMed