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@ARTICLE{Hubertus:302042,
      author       = {V. Hubertus and L. Viezens and M. Stangenberg and A. M.
                      Früh and H. S. Meyer and R. Liang and A. Kramer and C.
                      Orban and J. Kerschbaumer and B. Kunze and S. Telera and H.
                      Miller and C. J. Entenmann and E. J. von Bronewski and C.
                      Buhre and L.-G. Leonhardt and W. Willenbacher and I.
                      Kvitsaridze and D. Laue and M. Pumberger and T. Keller and
                      G. Acker and J. Krönke and I.-W. Blau and U. Keller and F.
                      Ringel and C. Thomé and B. Meyer and P. Vajkoczy and M.
                      Dreimann and J. S. Onken$^*$},
      title        = {{P}ractice variations in indication, timing and outcome of
                      {M}ultiple {M}yeloma patients undergoing surgery for
                      vertebral lesions - results from the {E}uropean {M}2{S}pine
                      study group.},
      journal      = {Journal of neuro-oncology},
      volume       = {174},
      number       = {3},
      issn         = {0167-594X},
      address      = {Dordrecht [u.a.]},
      publisher    = {Springer Science + Business Media B.V},
      reportid     = {DKFZ-2025-01233},
      pages        = {765-777},
      year         = {2025},
      note         = {2025 Sep;174(3):765-777},
      abstract     = {Painful 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.This 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.704 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.Surgical 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.},
      keywords     = {Chronic vertebral pain (Other) / Multiple myeloma (Other) /
                      Surgical complications (Other) / Surgical decision-making
                      (Other) / Vertebral column lesions (Other)},
      cin          = {BE01},
      ddc          = {610},
      cid          = {I:(DE-He78)BE01-20160331},
      pnm          = {899 - ohne Topic (POF4-899)},
      pid          = {G:(DE-HGF)POF4-899},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:40512280},
      doi          = {10.1007/s11060-025-05085-y},
      url          = {https://inrepo02.dkfz.de/record/302042},
}