Fratura na coluna vertebral por mieloma múltiplo: correlação entre sobrevida e índices de Tomita e Tokuhashi

Avanzi, Osmar; Landim, Elcio; Meves, Robert; Caffaro, Maria Fernanda Silber; Lima, Marcos Vaz de

doi:10.1590/s1808-18512009000100014

Cited by 4 publications

(11 citation statements)

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“…This put these patients in categories with less aggressive or conservative treatments, thereby modifying this form of conduct in the cases. In our practice, Avanzi et al 22 studied the correlation between spinal fractures and survival in patients with multiple myeloma using the Tokuhashi and Tomita scores. These authors were not able to predict survival using these scores.…”

Section: Discussionmentioning

confidence: 99%

Assessment of Scores in Decision Making in Metastases of the Spine

et al. 2015

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Objective: The aim of this study is to assess the intra-and interobserver concordance of SINS, Harrington, Tokuhashi and Tomita scores among general orthopedic surgeons and spine surgeons with experience above 5 and 10 years in the evaluation of patients with spinal metastasis. Methods: Twenty cases of patients with metastatic lesion of the spine were presented to 10 examiners and the scores aforementioned have been applied. After six weeks, the cases were reintroduced in a different order and data were analyzed. Results: The intraobserver reliability showed better agreement in SINS score among examiners with less experience and Harrington and Tomita scores among those who had more than 10-year experience. The interobserver reliability of the examiners of the group with over 10-year experience showed higher precision when using these scores, especially Harrington and Tomita. The SINS score was the choice for daily practice and was able to modify the management more often. Conclusions: This study demonstrated that the use of predictive scores of instability, Harrington, and prognosis, Tomita, had a higher intra-and interobserver reliability particularly among spine surgeons with experience above 10 years.Keywords: Prognosis; Neoplasm metastasis; Spinal neoplasms; Life expectancy. RESUMO Objetivo: O objetivo deste estudo é avaliar a concordância intra e interobservador dos escores SINS, Harrington

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Section: Discussionmentioning

confidence: 99%

Assessment of Scores in Decision Making in Metastases of the Spine

et al. 2015

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“…El mieloma múltiple (MM) se caracteriza por la proliferación descontrolada y clonal de los plasmocitos en la médula ósea, acompañada de la producción de inmunoglobulinas anómalas monoclonales, llamadas proteínas M [1] . Es la segunda enfermedad oncohematológica más común en el mundo, representa el 1% de todas las neoplasias malignas, con mayor prevalencia en mayores de 50 años [1,2] y una incidencia de 5-10/100 000 personas por año [3] . Ocurre preferentemente en hombres, su incidencia aumenta progresivamente con la edad (el 90% de los pacientes tiene más de 50 años de edad) y la edad media al momento del diagnóstico es de 70 años.…”

Section: Introductionunclassified

“…[4] . La supervivencia media del MM es de 24 a 36 meses, pero en casos sintomáticos y con lesión vertebral disminuye a seis meses [3] .…”

Section: Introductionunclassified

“…Las complicaciones más comunes del MM son la hipercalcemia, dolor óseo y fracturas en huesos del esqueleto apendicular y axial. Cuanto mayor es el compromiso del estado general y la diseminación de la enfermedad, peor será la sobrevida [3] . Raramente afecta a la piel (5 a 10% de los casos) [5] y la incidencia de casos de plasmocitoma (o lesión solitaria) que afecta a los testículos alcanza entre el 0,6% y el 2,7% del total de casos [6] .…”

Section: Introductionunclassified

“…Raramente afecta a la piel (5 a 10% de los casos) [5] y la incidencia de casos de plasmocitoma (o lesión solitaria) que afecta a los testículos alcanza entre el 0,6% y el 2,7% del total de casos [6] . Es poco frecuente que afecte órganos nobles, siendo el hígado uno de los más afectados (20%) [3] . El diagnóstico se basa en la combinación de características clínicas, laboratoriales e imagenológicas [4,5] .…”

Section: Introductionunclassified

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Mieloma múltiple con metástasis cutáneas y testiculares recurrente después trasplante autólogo de médula ósea: relato de caso

Brandenburg

Zanini²,

Schossler-Loss

2019

Acta Med Peru

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Mieloma múltiple con metástasis cutáneas y testiculares recurrente después trasplante autólogo de médula ósea: relato de caso Multiple myeloma with recurrent skin and testis metastases after an autologous bone marrow transplantation: report of a case RESUMENSe relata el caso de un paciente masculino de 56 años con mieloma múltiple (MM) y presencia de plasmocitomas en tejido celular subcutáneo y en testículo. El paciente tenía el antecedente de MM tratado con quimioterapia y trasplante autólogo de médula ósea y que después de 4 años de remisión de la enfermedad presentó recidiva ósea, la misma que fue tratada con quimioterapia e inmunoterapia. No hubo respuesta satisfactoria a los primeros ciclos del tratamiento con progresión de la enfermedad ósea y surgimiento de nódulos en dorso, puño y testículo sospechosos de recidiva de la enfermedad. Se procedió a resección de las lesiones en el dorso y puño que, en el examen anatomopatológico, fueron compatibles con neoplasia maligna y la prueba de inmunohistoquímica confirmó que se trataba de metástasis del MM. Se optó por la continuidad del tratamiento hasta completar los 12 ciclos propuestos, pero no hubo mejoría de las lesiones además de la aparición de nuevas lesiones en tejido celular subcutáneo y región perianal, con empeoramiento clínico. El paciente falleció después de dos meses de cuidados paliativos. ABSTRACTWe present the case of a 56-year old male subject with multiple myeloma (MM) and with plasmacytomas in both the subcutaneous tissues and testis. He had a past history of MM who underwent chemotherapy and autologous bone marrow transplantation. After four years with disease remission, he presented with bone relapse, and he received chemotherapy and immunotherapy. There was no satisfactory response to the first cycles of therapy, and there was progression of bone disease, and nodes suspicious of disease recurrence arose in the back, fists, and testes. Both back and fist lesions were resected. The anatomopathological examination showed they were compatible with malignancy, and immunohistochemistry testing confirmed MM metastases. It was decided to continue therapy for the 12 cycles originally proposed, but there was no improvement in the aforementioned lesions. New lesions appeared in subcutaneous tissues and the perianal region, and the patient's clinical condition worsened. He died after two months receiving palliative care.

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A Comparison of the Tomita and Tokuhashi Scores in Spinal Metastasis

et al. 2020

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Objective To compare Tokuhashi and Tomita scores in patients with epidural spinal metastasis who underwent surgical treatment. Methods A retrospective evaluation of 103 patients with spinal metastasis and epidural compression who underwent surgical treatment. An analysis was performed of agreement between the survival rates observed in the study sample and the survival rate estimated by the Tomita and Tokuhashi scales. Results The overall accuracy was 39.03% for the Tomita scale and 61.75% for the Tokuhashi scale. Fair agreement (0.38 weighted Cohen’s Kappa coefficient) was observed between patient survival and the Tokuhashi score, and slight agreement (0.25 weighted Kappa coefficient) for the Tomita score. The agreement for both scales was higher for patients with less than six months’ survival, with general accuracy of 79.17% for the Tomita and 70.59% for the Tokuhashi scoring system. Conclusion There was fair and slight agreement between the Tokuhashi and Tomita scores with patient survival group. The agreement was higher for patients with less than six months’ survival. Level of evidence III; Comparative retrospective study.

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Fratura na coluna vertebral por mieloma múltiplo: correlação entre sobrevida e índices de Tomita e Tokuhashi

Cited by 4 publications

References 16 publications

Assessment of Scores in Decision Making in Metastases of the Spine

Assessment of Scores in Decision Making in Metastases of the Spine

Mieloma múltiple con metástasis cutáneas y testiculares recurrente después trasplante autólogo de médula ósea: relato de caso

A Comparison of the Tomita and Tokuhashi Scores in Spinal Metastasis

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