Journal of Bone Oncology最新文献

{"title":"Treatment of myeloma bone disease: When, how often, and for how long?","authors":"Michael Tveden Gundesen ,&nbsp;Fredrik Schjesvold ,&nbsp;Thomas Lund","doi":"10.1016/j.jbo.2025.100680","DOIUrl":"10.1016/j.jbo.2025.100680","url":null,"abstract":"<div><div>The landscape of MM has changed dramatically in recent years. Several new and more effective treatments have been introduced that not only makes patients live longer but also brings them into a deeper remission. This makes the potential total exposure of bone protective treatment much higher but perhaps also less needed. New and more precise imagining techniques have been introduced making detection of bone disease more sensitive, and the introduction of SLiM-CRAB criteria have changed the parameters used in old clinical trials investigating treatment of MM bone disease. New data have also emerged investigating the effect of the RANKL inhibitor denosumab compared to zoledronic acid (ZOL). Randomized trials have investigated longer treatment durations, which becomes more relevant as patients now live longer.</div><div>In addition in this review, data regarding interval between individual treatment, impact of remission status, new data in relation to rebound after discontinuation and of denosumab, as well as the rational for drug holidays before dental procedures will also be discussed.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100680"},"PeriodicalIF":3.4,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143777626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Decoding the immune landscape in Ewing sarcoma pathogenesis: The role of tumor infiltrating immune cells and immune milieu","authors":"Rajiv Ranjan Kumar ,&nbsp;Nikita Agarwal ,&nbsp;Akshi Shree ,&nbsp;Jaya Kanta Gorain ,&nbsp;Ekta Rahul ,&nbsp;Shuvadeep Ganguly ,&nbsp;Sameer Bakhshi ,&nbsp;Uttam Sharma","doi":"10.1016/j.jbo.2025.100678","DOIUrl":"10.1016/j.jbo.2025.100678","url":null,"abstract":"<div><div>Ewing sarcoma (EwS) is the second most prevalent pediatric bone malignancy, characterized by its aggressive behavior and unfavorable prognosis. The tumor microenvironment (TME) of EwS is shaped by immunosuppressive components, including myeloid-derived suppressor cells, tumor-associated macrophages, and immune checkpoint molecules such as PD-1/PD-L1 and HLA-G. These elements impair anti-tumor immune responses by modulating the function of tumor-infiltrating immune cells, such as regulatory T cells (Tregs), CD8⁺ T cells, and natural killer cells. Chemokines, including CXCL9 and CXCL12, and cytokines, such as transforming growth factor-beta and interleukin-10, further contribute to immune suppression and promote metastatic dissemination. Recent advances in immunotherapy have highlighted the therapeutic potential of modulating immune cells and signaling pathways to enhance anti-tumor immunity. This review provides a comprehensive analysis of the complex immune landscape within the EwS TME, focusing on the mechanistic roles of key immune components and their potential as therapeutic targets. Understanding these interactions could pave the way for innovative treatment strategies to improve clinical outcomes in patients with EwS.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100678"},"PeriodicalIF":3.4,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143768815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone cement implantation syndrome in patients with cemented endoprostheses for metastatic bone disease in the femur","authors":"Thea Hovgaard Ladegaard ,&nbsp;Jakob Stensballe ,&nbsp;Michael Mørk Petersen ,&nbsp;Michala Skovlund Sørensen","doi":"10.1016/j.jbo.2025.100677","DOIUrl":"10.1016/j.jbo.2025.100677","url":null,"abstract":"<div><h3>Background</h3><div>Patients with bone metastases in the femur (BMf) may experience pathological fractures requiring surgery with cemented endoprostheses (EPR). At cementation and prosthesis insertion, patients are at risk of experiencing hypoxia, hypotension, cardiac failure and potentially death, known as bone cement implantation syndrome (BCIS). We aimed to 1) investigate the incidence and grade of BCIS in patients with BMf treated with cemented EPR, and 2) examine if the incidence or extent of BCIS has decreased after a change of a combined anesthesiologic and surgical protocol.</div></div><div><h3>Methods</h3><div>We retrospectively assessed patients with BMf operated with cemented EPR in two periods 2017 – 2018 (early cohort) and 2019 – 2020 (late cohort) and stratified before and after the intervention.</div></div><div><h3>Results</h3><div>Comparing the early and late cohorts, 26/86 (32 %) vs. 30/80 (35 %) experienced BCIS, but mild BCIS (grade 0 + 1) was seen in 79 % vs. 86 %, and severe BCIS (grade 2 + 3) in 21 % vs. 14 %. In the late cohort the per-operative use of vasopressors was higher (86 % vs. 59 %, p &lt; 0.001), we found fewer pulmonary embolisms (PE) (p = 0.024), and a trend toward a reduced length of stay (LOS). 30-day survival was lower for patients with grade 0 + 1 compared to grade 2 + 3 (p = 0.03).</div></div><div><h3>Conclusions</h3><div>BCIS occurs in more than 1/3 of patients operated for BMf with cemented EPR. An increased multidisciplinary focus on BCIS may reduce the complications of BCIS, such as PE and LOS.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100677"},"PeriodicalIF":3.4,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical management of spinal metastases: A cross-continental study in the United States and the Netherlands","authors":"Jantijn J.G.J. Amelink ,&nbsp;Bram T. van Munster ,&nbsp;Bas J.J. Bindels ,&nbsp;Robertus J.B. Pierik ,&nbsp;Jasper van Tiel ,&nbsp;Olivier Q. Groot ,&nbsp;Nicolien Kasperts ,&nbsp;Daniel G. Tobert ,&nbsp;Jorrit-Jan Verlaan","doi":"10.1016/j.jbo.2025.100676","DOIUrl":"10.1016/j.jbo.2025.100676","url":null,"abstract":"<div><h3>Background</h3><div>There is currently no consensus on the optimal surgical treatment for patients with spinal metastases. Investigating regional variations in surgical management could provide valuable insights to optimize care and refine surgical practices globally.</div></div><div><h3>Objective</h3><div>To investigate differences in patient populations, surgical management, and perioperative outcomes among patients who underwent surgery for spinal metastases in either Boston (United States) or Utrecht (Netherlands).</div></div><div><h3>Methods</h3><div>727 patients surgically treated for spinal metastases in Boston (n=539) and Utrecht (n=188) between 2018–2022 were included. Data on patient characteristics, surgical management, perioperative outcomes, and survival were collected. The Mann-Whitney <em>U</em> test was used for continuous data, and Fisher’s exact test for categorical data.</div></div><div><h3>Results</h3><div>In Boston, a higher percentage of patients had three or more spinal metastases (68% <em>vs</em> 59%; p=0.006) and brain metastases (16% <em>vs</em> 4.3%; p&lt;0.001) at the time of surgery compared with Utrecht. Vertebrectomy/corpectomy with stabilization was performed in 54% of patients in Boston versus none in Utrecht (p&lt;0.001), whereas percutaneous stabilization was performed in 1.3% of patients in Boston versus 39% in Utrecht (p&lt;0.001). In Utrecht, patients received postoperative radiotherapy more frequently (70% <em>vs</em> 54%; p&lt;0.001) and earlier (17 days [IQR:12–24] <em>vs</em> 29 days [IQR:23–39]; p&lt;0.001). Postoperative neurological outcome, complications, reoperation rates, and survival did not differ between the two cohorts (all p&gt;0.05).</div></div><div><h3>Conclusions</h3><div>Differences in patient populations and surgical management exist between tertiary hospitals on separate continents. Further research is needed to determine the optimal extent and timing of surgery to improve quality of life for patients with spinal metastases.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100676"},"PeriodicalIF":3.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143725228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-treatment late and long-term effects in bone sarcoma: A scoping review","authors":"Kaainat Khan ,&nbsp;Kathleen Kane ,&nbsp;Zoe Davison ,&nbsp;Darrell Green","doi":"10.1016/j.jbo.2025.100671","DOIUrl":"10.1016/j.jbo.2025.100671","url":null,"abstract":"<div><div>Despite the fact that chemotherapy for bone sarcomas (e.g. Ewing sarcoma, osteosarcoma) has well-reported toxicities and that surgical intervention is frequently life altering, follow-up care to monitor for late and long-term effects beyond that of oncological surveillance in former patients is variable. Anecdotal evidence suggests that inconsistent follow-up means some former bone sarcoma patients are left to cope with post-treatment late and long-term effects with limited support. Here, we performed a scoping review to provide a more empirical identification of the knowledge gaps and to provide an overview of the peer reviewed academic literature reporting the late and long-term effects of treatment for bone sarcoma. JBI Scoping Review Network guidelines for charting, analysis and data extraction were followed. Literature searches were conducted in Medline (Ovid), Cochrane CENTRAL, EMBASE (Ovid), CINAHL, PsycINFO, Proquest and Web of Science (Clarivate Analytics) from March 2024 to September 2024. Paper titles and abstracts were screened by two independent reviewers followed by full text analysis by the lead researcher. Seventy-four peer reviewed articles were included in the analysis. Most studies were of a retrospective study design, some up to 20 years of follow-up and included chemotherapy, surgery and sometimes radiotherapy as the treatment modality. Our analysis identified secondary malignancies, cardio- and nephrotoxicity, lower bone mineral density and microarchitectural deterioration, cancer related fatigue and motor neuropathies as the major physical late and long-term effects requiring dedicated follow-up. In some cases, follow-up may need to span decades, especially given the increasing population of former patients. Our results form the evidence-based foundations for future work that might include late and long-term effect follow-up service mapping exercises and expanded clinical recommendations.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100671"},"PeriodicalIF":3.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687979","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A novel bone metastasis-related gene signature for predicting prognosis, anti-androgen resistance, and drug choice in prostate cancer","authors":"Yu Luo ,&nbsp;Xiaoqi Deng ,&nbsp;Chengcheng Wei ,&nbsp;Zhangcheng Liu ,&nbsp;Liangdong Song ,&nbsp;Kun Han ,&nbsp;Yunfan Li ,&nbsp;Jindong Zhang ,&nbsp;Shuai Su ,&nbsp;Delin Wang","doi":"10.1016/j.jbo.2025.100673","DOIUrl":"10.1016/j.jbo.2025.100673","url":null,"abstract":"<div><h3>Objective</h3><div>Prostate cancer (PCa) often metastasizes to the bone, posing a significant clinical challenge. This study aims to develop a bone metastasis-related risk model for PCa.</div></div><div><h3>Methods</h3><div>Bone metastasis-related genes (BMRGs) were identified through a combination of differential gene expression analysis and WGCNA using GSE32269 and GSE77930 datasets. Consensus clustering analysis was employed to determine the significance of these genes in molecular subtyping of PCa. LASSO-Cox regression analysis was utilized to construct the bone metastasis-related prognostic gene signature (BMRPS). The predictive performance of BMRPS was assessed using ROC curves, Kaplan-Meier survival curves, and a predictive nomogram. The immune landscape heterogeneity of subgroups was analyzed using CIBERSORT, ESTIMATE, and xCell algorithms. Drug sensitivity and molecular docking analysis were performed to identify drugs associated with BMRPS.</div></div><div><h3>Results</h3><div>Forty-four BMRGs associated with the prognosis of PCa were identified. Consensus clustering revealed the pivotal role of these genes in stratifying PCa into three distinct prognostic clusters. The BMRPS, consisting of 14 BMRGs, demonstrated excellent predictive accuracy for prognosis and served as an independent prognostic factor in PCa. BMRPS effectively predicted the overall survival of bone metastatic PCa and differentiated bone metastasis from other metastatic types. BMRPS showed a close correlation with the immune landscape and immunotherapeutic response biomarkers. Additionally, BMRPS was associated with anti-androgen resistance, and AZD8186 was identified as a potential BMRPS-related drug that holds promise for personalized treatment in PCa.</div></div><div><h3>Conclusion</h3><div>BMRPS facilitates the prediction of prognosis and resistance to anti-androgens in PCa. It also offers insights into the molecular mechanisms of bone metastasis and aids in drug selection for the treatment of PCa.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100673"},"PeriodicalIF":3.4,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multiple Indeterminate pulmonary nodules (IPNs) as independent prognostic indicators in pediatric osteosarcoma: A ten-year retrospective study","authors":"Yao Weitao ,&nbsp;Du Xinhui ,&nbsp;Li Zhehuang ,&nbsp;Hou Jingyu ,&nbsp;Ma Shengbiao ,&nbsp;Zhang Panhong ,&nbsp;Niu Xiaohui","doi":"10.1016/j.jbo.2025.100674","DOIUrl":"10.1016/j.jbo.2025.100674","url":null,"abstract":"<div><h3>Background</h3><div>Osteosarcoma is the most common primary malignant bone tumor in pediatric and adolescent patients. Although pulmonary metastasis is a key driver of prognosis, the role of IPNs in risk stratification remains inadequately defined.</div></div><div><h3>Objective</h3><div>This study aims to assess the incidence, progression, and prognostic significance of IPNs in pediatric and adolescent osteosarcoma patients, providing insights for clinical staging and treatment strategy development.</div></div><div><h3>Methods</h3><div>We retrospectively analyzed clinical data from 126 osteosarcoma patients aged 20 years or younger who were treated at Henan Cancer Hospital between January 2012 and January 2022. Pre-treatment thin-slice computed tomography (CT) scans of lung were used to categorize patients into three groups: no IPN (n = 100), solitary IPN (n = 16), and multiple IPNs (n = 10). Baseline characteristics, primary tumor parameters, treatment modalities, and follow-up data were collected. Univariate and multivariate analyses were conducted to assess risk factors and survival outcomes.</div></div><div><h3>Results</h3><div>The overall incidence of IPNs was 20.6 %, with multiple IPNs accounting for 38.5 % of the IPN-positive cases. A significantly higher proportion of patients in the IPN-positive group had bone involvement exceeding one-third of the total affected bone compared to the no-IPN group (57.7 % vs. 34.0 %, p = 0.016). While univariate analysis suggested a potential association between tumor diameter &gt; 8 cm and IPN occurrence (odds ratio [OR] = 2.08, 95 % confidence interval [CI]: 0.83–5.21, p = 0.120), this was not statistically significant in multivariate analysis (OR = 3.61, p = 0.283). Kaplan–Meier survival analysis revealed that the 3-year metastasis-free survival (MFS) and overall survival (OS) rates in the IPN-positive group were significantly lower than those in the no-IPN group (MFS: 57.7 % vs. 64.0 %, p = 0.03; OS: 65.4 % vs. 76.0 %, p = 0.04). Further subgroup analysis indicated that while solitary IPN cases had survival outcomes comparable to those without IPNs, multiple IPN cases exhibited a markedly reduced 5-year OS (30.0 % vs. 69.0 %, p = 0.045). Cox regression analysis demonstrated that multiple IPNs increased the risk of death by 2.87-fold (hazard ratio [HR] = 2.87, p = 0.020).</div></div><div><h3>Conclusion</h3><div>Indeterminate Pulmonary Nodules are relatively common in pediatric osteosarcoma patients. In particular, multiple IPNs are strongly associated with a higher tumor burden and increased metastatic potential, serving as an independent indicator of poor prognosis. These findings emphasize the importance of preoperative IPN assessment and risk stratification in guiding individualized treatment strategies.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100674"},"PeriodicalIF":3.4,"publicationDate":"2025-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pain in patients with multiple inherited osteochondromas: Incidence and potential prognostic factors. A retrospective cohort study","authors":"Morena Tremosini ,&nbsp;Mattia Morri ,&nbsp;Cristiana Forni ,&nbsp;Elena Pedrini ,&nbsp;Marina Mordenti ,&nbsp;Maria Gnoli ,&nbsp;Alessia Di Cecco ,&nbsp;Alice Moroni ,&nbsp;Luca Sangiorgi","doi":"10.1016/j.jbo.2025.100672","DOIUrl":"10.1016/j.jbo.2025.100672","url":null,"abstract":"<div><h3>Purpose</h3><div>the purpose of this study was to describe the baseline characteristics, presenting phenotype and treatment interventions for patients diagnosed with multiple osteochondromas who presented with severe pain symptoms.</div></div><div><h3>Methods</h3><div>a retrospective single-centre cohort study was conducted at a Rare Skeletal Disorders Department. Pain symptomatology was measured at the first visit, pain level was reported, varying from 0, absence of pain to 10, maximum pain. Baseline characteristics, pathology phenotype using IOR classification and treatments performed/ongoing as medical, surgical and conservative therapies were collected.</div></div><div><h3>Results</h3><div>a total of 152 patients were enrolled, with a median pain score of 0 and the 25th and 75th percentiles of 0 and 4, respectively. A percentage of 25.7 % (95 % CI of 19.3–33.3) presented at the first visit with moderate/severe pain. Multiple logistic regression confirmed that age was the only factor to be significantly associated with moderate/severe pain and IOR classification was not able to provide a description of the pathology that was associated with a major pain score.</div></div><div><h3>Conclusion</h3><div>from the early stages of multiple osteochondromas diagnosis<strong>,</strong> pain symptoms must be carefully assessed. An increase in age is associated with a worsening of pain; IOR classification of the multiple osteochondromas phenotype does not currently allow an association between the various classes and pain. A re-evaluation of the classification in this light could be an important new element for clinical practice.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100672"},"PeriodicalIF":3.4,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health- related quality of life after surgery for spinal metastases","authors":"Silvia Terzi ,&nbsp;Cristiana Griffoni ,&nbsp;Simona Rosa ,&nbsp;Chiara Cini ,&nbsp;Emanuela Asunis ,&nbsp;Chiara Alcherigi ,&nbsp;Federica Trentin ,&nbsp;Stefano Bandiera ,&nbsp;Riccardo Ghermandi ,&nbsp;Giuseppe Tedesco ,&nbsp;Gisberto Evangelisti ,&nbsp;Marco Girolami ,&nbsp;Valerio Pipola ,&nbsp;Giovanni Barbanti Brodano ,&nbsp;Alessandro Gasbarrini","doi":"10.1016/j.jbo.2025.100675","DOIUrl":"10.1016/j.jbo.2025.100675","url":null,"abstract":"<div><h3>Background</h3><div>Surgery for spinal metastases is almost always palliative and part of a multidisciplinary approach that has determined a significant increase of life expectancy in the last decade; thus, an improvement in health-related quality of life (HRQOL) is the main goal of the treatment of spinal metastases. We report here the results of a prospective study conducted with the aim of evaluating the impact of spinal surgery on HRQOL, measured by Patient-Reported Outcomes Measures (PROMs). We analyzed clinical outcomes (ambulatory status, performance status, pain, neurological status) and HRQOL scores (VAS, EQ5D, SF36) during the follow-up period and focused on factors that could affect quality of life, considering both psychological and physical issues.</div></div><div><h3>Methods</h3><div>169 patients (96 males, 73 females) with vertebral metastases who underwent surgery at a tertiary referral center were consecutively enrolled from August 2018 to October 2022. Clinical and surgical data were prospectively collected, and PROMs (VAS, EQ-5D and SF-36) were registered before surgery and during follow up.</div></div><div><h3>Results</h3><div>The overall survival was 22 months, and a 61 % survival rate was registered at 1 year follow-up. We observed a significant improvement in walking ability, general performance status, pain and HRQOL after surgery, which was maintained during the follow up. Multivariate analysis identified three independent variables, capable of influencing the trend of HRQOL after surgery: the presence of pathological fracture, the preoperative neurological status and the local recurrence of disease.</div></div><div><h3>Discussion</h3><div>This study confirms the effectiveness of surgery for spinal metastases in improving patients’ performance status and demonstrates an overall improvement in HRQOL, which is maintained over time.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"52 ","pages":"Article 100675"},"PeriodicalIF":3.4,"publicationDate":"2025-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143687703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of myosteatosis on prognosis in multiple myeloma patients: A subgroup analysis of 182 cases and development of a nomogram","authors":"Jun-Peng Liu ,&nbsp;Xing-Chen Yao ,&nbsp;Ming Shi ,&nbsp;Zi-Yu Xu ,&nbsp;Yue Wu ,&nbsp;Xiang-Jun Shi ,&nbsp;Meng Li ,&nbsp;Xin-Ru Du","doi":"10.1016/j.jbo.2025.100670","DOIUrl":"10.1016/j.jbo.2025.100670","url":null,"abstract":"<div><h3>Background</h3><div>This study aims to explore the prognostic value of myosteatosis in multiple myeloma (MM) and to analyze the factors influencing myosteatosis.</div></div><div><h3>Methods</h3><div>A retrospective analysis was conducted on 182 patients treated for MM at our institution from 2009 to 2020 who underwent MRI examinations. The fatty infiltration rate (FIR) of the erector spinae and multifidus muscles at the L3 level was measured to assess the degree of myosteatosis. Patients were grouped based on fracture presence and median FIR, and group differences were compared, with P &lt; 0.05 considered statistically significant. Survival and fractures were used as prognostic indicators, and regression analysis was performed to determine the impact of FIR on these outcomes in MM patients. The factors influencing FIR were analyzed, and the relationship between myosteatosis and MM prognosis was further analyzed within its sensitive subgroups. Finally, a nomogram based on FIR was established and validated.</div></div><div><h3>Results</h3><div>Significant differences were observed between the fracture and non-fracture groups in lactate dehydrogenase, serum phosphorus, visual analogue scale, oswestry disability index and FIR (P &lt; 0.05). When patients were grouped based on the median FIR (28.89 %), there were significant differences in age, sex, body mass index (BMI), red blood cell (RBC) count, hemoglobin, hematocrit, albumin, visual analogue scale, oswestry disability index, and fracture incidence (P &lt; 0.05). Univariate COX regression analysis indicated that myosteatosis had no significant impact on survival prognosis in MM patients (HR = 0.999, P = 0.852), with a log-rank test P value of 0.11 when grouped by the cut-off FIR value of 33.67 %. Multivariate logistic regression indicated that FIR is an independent predictor of fractures (OR = 1.054, P = 0.000). Multivariate linear regression revealed that age, sex, RBC count, and BMI are independent factors influencing FIR (P &lt; 0.05). When not grouped, FIR’s prediction of fractures showed no significant interaction with age, sex, RBC count, or BMI (P for interaction &gt; 0.05). In subgroups with BMI ≥ 25 kg/m² or RBC count &gt; 3.68 × 10^12/L, FIR lost its predictive significance for fractures. The FIR nomogram model had a C-index of 0.777, and the calibration curve, decision curve analysis, and clinical impact curve all validated its effectiveness.</div></div><div><h3>Conclusions</h3><div>Myosteatosis characterized by FIR is not a reliable predictor of survival in MM patients but is effective in predicting fractures and is closely related to back pain and functional impairment. FIR is significantly associated with age, sex, RBC count, and BMI.</div></div>","PeriodicalId":48806,"journal":{"name":"Journal of Bone Oncology","volume":"51 ","pages":"Article 100670"},"PeriodicalIF":3.4,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143621301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}