[Billy1]

The Durie-Salmon PLUS Staging System

by Billy1 on Thu Jun 02, 2011 5:17 pm

The Durie-Salmon PLUS Staging System for multiple myeloma was published in 2006 and does not seem to have gotten much attention in the US, at least to the layman.

The main differance between the Durie-Salmon system, which has been around for years, and the Durie-Salmon PLUS system is the addition of whole body imaging techniques such as MRI , PET, and CT for bone marrow morbidity.
The Durie-Salmon system has for years recognised full Skeletal Survey X-Rays as being adequate for staging of multiple myeloma. The "PLUS" system however, in articles published in PubMed and the European Journal of Cancer (among others) questions the adequacy of Skeletal Survey in determining bone lyctic lesions and tumour load in patients.

The addition of whole body imaging such as MRI according to these articles has revealed a large number of patients which would have been staged differantly between the two systems. One article states that of 84 cases diagnosed with MGUS, 33 (39%) would have been re-classified. In almost all cases higher counts were obtained by imaging procedures such as MRI which could result in a worse classification.
In addition data show very poor concordance of about 45% between Durie-Salmon and Durie-
Salmon PLUS.
The fact that the "PLUS" system receives such little comment is rather odd and could lead one to believe that some oncologists are not even aware of it.

Regards from the West Coast.
Billy

Billy