Evidence map›Paper›PMID 40512280›Full record

ArticleJournal of neuro-oncology2025

Practice variations in indication, timing and outcome of Multiple Myeloma patients undergoing surgery for vertebral lesions - results from the European M2Spine study group.

Vanessa Hubertus, Lennart Viezens, Martin Stangenberg, Anton M Früh, Hanno S Meyer, Raimunde Liang, Andreas Kramer, Christoph Orban, Johannes Kerschbaumer, Beate Kunze and 21 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of neuro-oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

31 authors.

Vanessa HubertusDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Lennart ViezensDivision of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Martin StangenbergDivision of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Anton M FrühDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Hanno S MeyerDepartment of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Raimunde LiangDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Andreas KramerDepartment of Neurosurgery, University Hospital Mainz, Johannes-Guttenberg-University Mainz, Mainz, Germany.
Christoph OrbanDepartment of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria.
Johannes KerschbaumerDepartment of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria.
Beate KunzeSpine Center Markgröningen, Markgröningen, Germany.
Stefano TeleraIRCCS Regina Elena National Cancer Institute, Rome, Italy.
Hannah MillerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Christian J EntenmannDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Emily J von BronewskiDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Charlotte BuhreDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Leon-Gordian LeonhardtDivision of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Wolfgang WillenbacherDepartment of Internal Medicine, Hematology and Oncology, Comprehensive Cancer Center Innsbruck (CCCI), Austrian Comprehensive Cancer Network (ACCN), Tyrolean Cancer Research Center (TKFI), Medical University of Innsbruck, & Syndena GmbH, Connect to Cure, Innsbruck, Austria.
Irma KvitsaridzeDepartment of Radiation Oncology, Medical University of Innsbruck, Innsbruck, Austria.
Dominik LaueDepartment of Orthopedic and Trauma Surgery, Campus Benjamin Franklin, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Matthias PumbergerDepartment of Orthopedic and Trauma Surgery, Center for Musculosceletal Surgery, Campus Berlin Mitte and Campus Virchow, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt- Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Theresa KellerInstitute of Biometry and Clinical Epidemiology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.
Güliz AckerDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Jan KrönkeDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Igor-Wolfgang BlauDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Ulrich KellerDepartment of Hematology, Oncology, and Cancer Immunology, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Berlin, Germany.
Florian RingelDepartment of Neurosurgery, University Hospital Mainz, Johannes-Guttenberg-University Mainz, Mainz, Germany.
Claudius ThoméDepartment of Neurosurgery, Medical University of Innsbruck, Innsbruck, Austria.
Bernhard MeyerDepartment of Neurosurgery, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.
Peter VajkoczyDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany.
Marc DreimannDivision of Spine Surgery, Department of Trauma and Orthopedic Surgery, University Medical Center Hamburg- Eppendorf, Hamburg, Germany.
Julia Sophie OnkenDepartment of Neurosurgery, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Charitéplatz 1, 10117, Berlin, Germany. julia.onken@charite.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposePainful vertebral lesions are pathognomonic in Multiple Myeloma (MM). While non-surgical management is generally preferred, some patients ultimately require surgical intervention. Here we describe the largest European cohort of MM patients with vertebral lesions to examine the practice variations of spine surgery in means of indication, timing and outcome.

methodsThis study included patients with MM vertebral lesions enrolled in the European M2Spine Registry (DRKS00033326) at seven European academic spine centers between 2005 and 2023. Retrospective analysis evaluated epidemiological, clinical, and oncological treatment, focused on surgical management. Uni- and multivariate analyses identified factors associated with a decision towards spine surgery, including transitions from initially intended non-surgical approaches.

results704 patients were enrolled and 493 (70%) surgically treated. Main indications for surgery were refractory vertebral pain (41%) and neurological deficits (22%). Radiological and clinical parameters indicating spinal instability as assessed retrospectively were present in 32% but associated with surgical management in only 43%. 338 patients (48%) underwent surgery during early disease stage, while 110 (16%) received delayed surgery (median: 42 months, range: 12-306 months). Statistical analysis revealed lower MM grading (ISS) at diagnosis (p < 0.001), and a new onset of neurological deficits (p < 0.001) as the most significant indicators for a cross-over from intended non-surgical to surgical treatment. Of the 78% of patients available for neurological follow up, 94% of surgically treated patients showed an improved or stable neurological status after a median of 45 months.

conclusionSurgical intervention proved to be a viable option for patients with refractory pain and neurological deficits. Data from future prospective studies are necessary to evaluate the clinical trajectory of surgical and non-surgical treatment, and to ultimately provide evidence-based surgical treatment guidelines for MM patients.

Indexed as

Multiple MyelomaNeurosurgical ProceduresPractice Patterns, Physicians'Spinal NeoplasmsAdultAgedAged, 80 and overEuropeFemaleFollow-Up StudiesHumansMaleMiddle AgedRegistriesRetrospective StudiesTreatment OutcomeChronic vertebral painMultiple myelomaSurgical complicationsSurgical decision-makingVertebral column lesions

Identifiers

PMID40512280
PMCPMC12263761

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