PKP/PVP combine chemotherapy in the treatment of multiple myeloma patients with vertebral pathological fractures: minimum 3-year follow-up of 108 cases

Yao, Xingchen; Xu, Ziyu; Du, Xinru

doi:10.1186/s13018-019-1078-0

Cited by 9 publications

(3 citation statements)

References 21 publications

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“…Metastatic carcinoma of the spine is one of the most common clinical spinal diseases; it is mainly caused by extra-osseous malignant tumors that spread to the spine through hematogenous spread or lymphatic metastasis [ 7 , 8 ] and characterized by the involvement of multiple vertebral bodies. Metastatic lesions often cause severe pain in patients due to the destruction of the vertebral body by tumor cells, resulting in the fracture or collapse of the vertebral body and inflammation, and by the stimulation of peripheral nerve endings by tumor cells.…”

Section: Discussionmentioning

confidence: 99%

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Geng

et al. 2020

BMC Neurol

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Background To investigate the clinical efficacy and safety of bone cement combined with radiofrequency ablation (RFA) in the treatment of spinal metastases. Methods The medical records of patients with spinal metastatic tumor admitted to our hospital from January 2016 to December 2018 were retrospectively analyzed. Based on different surgical methods, the patients were divided into groups A (treated with RFA combined with bone cement) and B (treated with bone cement only). Group A included 35 patients with 47 segments of diseased vertebral bodies. Group B consisted of 52 patients with 78 vertebral segments. Pain, quality of life score, vertebra height, bone cement leakage, postoperative tumor recurrence, and complications were assessed 3 days and 1 and 6 months after surgery. Results All the patients had smooth operation without paraplegia, spinal cord injury, and perioperative death. Visual analogue scales (VAS) and Oswestry Disability Index (ODI) scores of the two groups significantly improved 3 days and 1 month after surgery compared with those before surgery (P < 0.05), but no significant difference was observed between the two groups (P > 0.05). Six months after surgery, the VAS and ODI scores of patients in group A were lower than those in group B, with statistically significant differences (P < 0.05). The postoperative vertebral body height of the two groups significantly increased compared with that before surgery, and the difference was statistically significant (P < 0.05). Meanwhile, no significant difference was observed between the two groups (P > 0.05). Postoperative bone cement permeability in group A was 6.4%, and postoperative tumor recurrence rate was 11.4%. The permeability of bone cement in group B was 20.5%, and the tumor recurrence rate was 30.8%. The bone cement permeability and tumor recurrence rate in group A were lower than those in group B, with statistically significant differences (P < 0.05). Conclusions Bone cement combined with RFA for the treatment of spinal metastases can achieve good efficacy, desirable analgesic effect, low incidence of complications, small surgical trauma, and high safety. The proposed method has the value of clinical popularization and application.

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Section: Discussionmentioning

confidence: 99%

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Geng

et al. 2020

BMC Neurol

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“…Bisphosphonates, denosumab and antineoplastic drugs for MM can relieve bone pain, but the onset of action is slow. On this basis, combined PKP/PVP minimally invasive surgery is an effective treatment for rapid relief of bone pain in MM patients [ 22 , 23 ] and also reduces the risk of complete bed rest and pulmonary infection, improves the quality of life of patients, and can lay the foundation for subsequent treatment [ 24 ]. A prospective randomized controlled trial enrolled 134 cancer patients (49 of whom were MM) and compared PKP surgery with nonsurgical treatment for painful vertebral compression fractures, finding that patients in the PKP surgery group achieved more rapid and sustained pain relief, significantly reduced time on pain medication and bed rest, and significantly improved quality of life compared to the nonsurgical group [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Risk–benefit ratio of percutaneous kyphoplasty and percutaneous vertebroplasty in patients with newly diagnosed multiple myeloma with vertebral fracture: a single-center retrospective study

Xiang

Cui

et al. 2023

Ann Hematol

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The indications for percutaneous kyphoplasty (PKP) and percutaneous vertebroplasty (PVP) are painful vertebral compression fractures. Our study is to assess the risk–benefit ratio of PKP/PVP surgery in the patients with newly diagnosed multiple myeloma (NDMM) without receiving antimyeloma therapy. The clinical data of 426 consecutive patients with NDMM admitted to our center from February 2012 to April 2022 were retrospectively analyzed. The baseline data, postoperative pain relief, the proportion of recurrent vertebral fractures, and survival time were compared between the PKP/PVP surgical group and the nonsurgical group in the NDMM patients. Of the 426 patients with NDMM, 206 patients had vertebral fractures (206/426, 48.4%). Of these, 32 (32/206, 15.5%) underwent PKP/PVP surgery for misdiagnosis of simple osteoporosis prior to diagnosis of MM (surgical group), and the other 174 (174/206, 84.5%) did not undergo surgical treatment prior to definitive diagnosis of MM (non-surgical group). The median age of patients in the surgical and nonsurgical groups was 66 and 62 years, respectively (p = 0.01). The proportion of patients with advanced ISS and RISS stages was higher in the surgical group (ISS stage II + III 96.9% vs. 71.8%, p = 0.03; RISS stage III 96.9% vs. 71%, p = 0.01). Postoperatively, 10 patients (31.3%) never experienced pain relief and 20 patients (62.5%) experienced short-term pain relief with a median duration of relief of 2.6 months (0.2–24.1 months). Postoperative fractures of vertebrae other than the surgical site occurred in 24 patients (75%) in the surgical group, with a median time of 4.4 months postoperatively (0.4–86.8 months). Vertebral fractures other than the fracture site at the first visit occurred in 5 patients (2.9%) in the nonoperative group at the time of diagnosis of MM, with a median time of 11.9 months after the first visit (3.5–12.6 months). The incidence of secondary fractures was significantly higher in the surgical group than in the nonsurgical group (75% vs. 2.9%, p = 0.001). The time interval between the first visit and definitive diagnosis of MM was longer in the surgical group than in the nonsurgical group (6.1 months vs. 1.6 months, p = 0.01). At a median follow-up of 32 months (0.3–123 months), median overall survival (OS) was significantly shorter in the surgical group than in the nonsurgical group (48.2 months vs. 66 months, p = 0.04). Application of PKP/PVP surgery for pain relief in NDMM patients without antimyeloma therapy has a limited effect and a high risk of new vertebral fractures after surgery. Therefore, patients with NDMM may need to have their disease controlled with antimyeloma therapy prior to any consideration for PKP/PVP surgery.

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“…Such studies are based on the characteristics of patients, tumor load and cytogenetics [1] , and mainly target the selection of chemotherapy regimens and other medical treatments. However, there is little literature on prognosis strati cation of MM surgical treatment [2][3][4] .…”

Section: Introductionmentioning

confidence: 99%

Significance of Preoperative Peripheral Blood Neutrophil-lymphocyte Ratio in Predicting Postoperative Survival in Patients with Multiple Myeloma Bone Disease

Yao

Shi

et al. 2020

Preprint

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Background: By observing the change characteristics of NLR at different stages after operation, to make a preliminary analysis of the effect of operation on the immune status of MM patients and study the prognostic value of peripheral blood NLR in predicting the treatment of multiple myeloma bone disease (MMBD).Method: The clinical data of 82 MMBD patients who underwent operations in our hospital were collected, which to analyze the effect of preoperative peripheral blood NLR on the prognosis of MMBD patients; Peripheral blood lymphocyte percentage was taken as the major observation indicator to analyze the change characteristics of the immune status of MM patients.Results: Data showed that the NLR cut-off values of the NLR≥3 group and NLR≥4 group were significantly correlated with POS. The POS of NLR≥3 patients (14.86±14.28) was significantly shorter than that of NLR＜3 patients (32.68±21.76). The lymphocyte percentage 1 week after operation (19.329±9.083) was significantly lower than that before operation (25.723±11.016). Survival analysis showed that postoperative chemotherapy and preoperative peripheral blood NLR were independent risk factors for POS.Conclusions: NLR was significant for the prediction of the POS of MMBD patients treated with operation, and MMBD patients with high preoperative NLR (NLR≥3) had a poorer prognosis and shorter POS. The immune status of MMBD patients was at a normal low level, and significantly declined after operation.Trial registration: As this was a retrospective study, it did not require ethical approval; all patients had signed informed consent when they received treatment, and all treatment options were voluntary.

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PKP/PVP combine chemotherapy in the treatment of multiple myeloma patients with vertebral pathological fractures: minimum 3-year follow-up of 108 cases

Cited by 9 publications

References 21 publications

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Clinical efficacy and safety of bone cement combined with radiofrequency ablation in the treatment of spinal metastases

Risk–benefit ratio of percutaneous kyphoplasty and percutaneous vertebroplasty in patients with newly diagnosed multiple myeloma with vertebral fracture: a single-center retrospective study

Significance of Preoperative Peripheral Blood Neutrophil-lymphocyte Ratio in Predicting Postoperative Survival in Patients with Multiple Myeloma Bone Disease

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