MM Patients May Benefit From Surgery, Regardless of Lesion Location

June 27, 2018

Preoperative pain, prothrombin time activity (PTA), albumin, urine protein, and postoperative chemotherapy appeared to be associated with prognosis.

Surgical treatment appears to be an effective approach for improving care in patients with multiple myeloma (MM), regardless of whether the lesion is located in the spine or in the long bone and soft tissue, a small retrospective study suggests. The study, reported in Oncology Letters, also demonstrated that preoperative pain, prothrombin time activity (PTA), albumin, urine protein, and postoperative chemotherapy appear to be associated with prognosis following surgery in this patient population.

Until now, no previous studies had been conducted that compared surgical outcomes in MM patients treated at different surgical sites. Jiangtao Shen, from Beijing Luhe Hospital, Capital Medical University, Beijing, China, and colleagues divided the 65 cases into two groups. Group A comprised patients with lesions located in the spine, and Group B included patients with lesions in the long bone or soft tissue. The researchers measured pain relief with a visual analogue scale (VAS). They also measured neurologic impairment and conducted a Cox regression analysis in order to estimate the effect of a variety of patient-related factors on survival outcomes.

This current investigation included 40 males and 25 females with MM. The mean age was 57.23 years (range, 20 to 79 years). All patients were consecutively treated with surgery at a single institution between January 2010 and January 2015.

Shen et al found that in both groups there were significant improvements in both pain relief and quality of life. In addition, no significant differences were observed for the majority of parameters compared between the two groups. However, in assessing hospitalization time, preoperative duration of symptoms, complications, recurrence, and survival time, they observed differences between the two groups in terms of surgery duration and postoperative VAS scores at 1 month and 6 months after surgery.

In Group A, 18 patients had died and 15 were still alive at the last follow-up. In Group B at last follow-up, 14 patients had died and 18 were still alive. Several risk factors appeared to be significantly associated with survival; these included the preoperative VAS score, postoperative chemotherapy, PTA, albumin, lactate dehydrogenase, and urine protein level.

The investigators concluded that surgical treatment appears to be an effective therapeutic approach in patients with MM. They advised that postoperative use of analgesics should be individualized according to the different surgical sites and postoperative periods. Since studies evaluating the outcomes of MM patients treated with surgery at different sites are limited, Shen et al said, further research is warranted.