Enhancing prognosis in multiple myeloma bone disease: insights from a retrospective analysis of surgical interventions.

Background: Multiple myeloma (MM) is a hematological malignancy characterized by bone marrow infiltration and osteolytic tumor formation. Despite advancements in the treatment of this disease, MM remains incurable and often leads to complications, such as multiple myeloma bone disease (MMBD). Surgical intervention is frequently necessary to manage symptoms associated with bone disease, including pain and fractures. Methods: A retrospective review was conducted on 135 patients diagnosed with MMBD who had undergone surgery, compared to 190 patients diagnosed with MM who had not undergone surgery and served as controls. Surgical interventions were performed based on typical clinical presentations of myeloma-related bone disease, as indicated by imaging results. Patients who had only undergone percutaneous kyphoplasty or vertebroplasty (PKP/PVP) were excluded from this study. Results: Among patients who underwent surgery, the spine was the most common site of bone metastasis, accounting for 50% of cases. The number of operations (overall survival [OS], Conclusions: These results indicate that surgery and chemotherapy together improved patient survival rates compared to chemotherapy alone, thereby facilitating patients' acceptance of systemic chemotherapy. Furthermore, the appropriate timing of surgery contributes to the positive prognoses of patients with MMBD.