Surgical treatment and prognostic analysis for multiple myeloma

ZHANG Xue-wei; DU Xin-ru; CHEN Wen-ming

doi:10.3969/j.issn.2095-252X.2014.07.005

Abstract：Objective To summarize the clinical outcomes of 32 patients receiving surgical treatment for multiple myeloma ( MM ) and skeletal-related events, and to analyze the postoperative survival status.Methods From November 2004 to November 2010, 40 operations were performed on 32 patients with MM, including 24 cases in the spine, 11 cases in the long bone and pelvis, 4 cases of soft tissue tumor resection and 1 case in the skull. The mean follow-up period was 14.0 months. The pain was evaluated according to the Visual Analogue Scale ( VAS ) scores. The survival was estimated by the Kaplan-Meier ( K-M ) method. The Cox regression analysis was used to estimate the prognostic risk factors.Results Pain relief was evident in 24 patients ( 92.3% ) among 26 patients whose main symptom was pain before the surgery. The VAS scores were 7.2 points before the surgery, 3.4 points at 1 month after the surgery and 0.8 points at 6 months after the surgery. Twelve out of 19 patients with neurological deifcits got improved ( 63.2% ). The neurological status was improved from Frankel C to D in 5 cases, from Frankel B to D in 2 cases, from Frankel B to C in 2 cases, from Frankel A to B, A to C and D to E each in 1 case. The median postoperative survival time was 22 months by the K-M method. The postoperative 1- and 3- year overall survival rates were 70%and 38% respectively. The univariate Cox regression analysis revealed signiifcant survival risk factors, including the preoperative course≥12 months ( relative risk [ RR ] 11.199,P=0.023 ), single operation ( RR 5.273,P=0.045 ) and anemia ( RR 5.171,P=0.034 ).Conclusions Surgical intervention seems to be 1 of the effective methods for MM and skeletal-related events. The preoperative course, number of operations and anemia may be the signiifcant predictors of mortality, which need to be further studied.