title: Predictors of survival in patients with surgical spine multiple myeloma metastases.
abstract: BACKGROUND
  Multiple myeloma (MM) is the most common primary malignant tumor of the spine and bone. Spinal metastases are part of the evolution and progression of the MM disease. Therefore, this study aims at investigating prognostic factors associated with overall survival (OS) in patients with symptomatic spine MM metastases.
  
  
  METHODS
  Consecutive spine surgery procedures were performed in the largest series reported to date and comprising 51 patients with osteolytic vertebral compression fractures resulting from MM, diagnosed by either bone marrow or tumor biopsy.
  
  
  RESULTS
  The mean age of patients was 61.1 years and mean follow-up was 31.9 months. Through univariate analyses, ISS stage (p < 0.0001), preoperative spine instability (SINS score) (p < 0.03), posterior osteosynthesis fixation (p < 0.002), preoperative adjuvant therapy (p < 0.02), postoperative adjuvant treatment (p < 0.001), bone marrow transplant (p < 0.03) and newly MM diagnosed (p < 0.03) emerged as powerful predictors of survival. Cox multivariate proportional hazard model indicated that only ISS Stage and stabilization surgery such as osteosynthesis were two independent predictive factors for OS [hazard ratio (HR): 0.268, 95% confidence interval (CI) 0.07-0.536; p < 0.006 for the former and HR: 0.184, 95% confidence interval (CI) 0.03-0.89; p < 0.04 for the latter].
  
  
  CONCLUSIONS
  Stabilization surgery combined to ISS staging should be considered as an important prognostic survival factor for patients with symptomatic MM spine metastases.
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France. Electronic address: aymmed@hotmail.fr.
authors: Aymeric
authors: A
authors: Amelot
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
authors: Alexis
authors: A
authors: Moles
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
authors: Joseph
authors: J
authors: Cristini
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
authors: Celine
authors: C
authors: Salaud
authors: Department of Hematology, Nantes University Hospital, France.
authors: Cyrille
authors: C
authors: Touzeau
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
authors: Olivier
authors: O
authors: Hamel
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
authors: Eric
authors: E
authors: Bord
authors: Department of Neurotrauma/Neurosurgery, Nantes University Hospital, France.
authors: Kevin
authors: K
authors: Buffenoir
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D009367:Neoplasm Staging; D011183:Postoperative Complications; D011379:Prognosis; D013125:Spinal Neoplasms / Q000401:mortality* / Q000556:secondary / Q000601:surgery; D015996:Survival Rate
keywords: Metastases; Myeloma; Oncology; Prognosis; Spine; Survival