[The predictive value of the Tokuhashi revised scoring system for the survival time of patients with spinal metastases].

OBJECTIVE: To evaluate the predictive value of the Tokuhashi revised scoring system for the life expectancy of patients with spinal metastases.

METHODS: A retrospective review of 447 patients with spinal metastases was performed, which comprised 291 men and 156 women with a mean age of 56. 1 years. All of the patients were scored with the Tokuhashi revised scoring system based on the available clinical, pathological and radiographic data. The relation between the survival time and the Tokuhashi revised score was analyzed.

RESULTS: The patients had a median survival time of 7. 9 months and a mean Tokuhashi revised score of 8. 23 points. The median survival time of 155 patients with high grade primary tumor of lung, liver, gastrointestinal tract, esophagus, bladder and pancreas was 4. 7 months. The median survival time of 146 patients with low grade primary tumor of thyroid, breast and prostate was 12 months. The median survival time of 146 patients with medium grade primary tumor of kidney, lymphoma, ovary and uterus, and unknown primary tumor was 7. 1 months. The median survival time of 211 patients with the Tokuhashi revised score of 0 to 8 points was 4 months. The median survival time of 147 patients with the Tokuhashi revised score of 9 to 11 points was 10 months. The median survival time of 89 patients with the Tokuhashi revised score of 12 to 15 points was 29 months. The differences between the groups were significant (P<0. 01 or 0. 0001). The Tokuhashi revised score was positively correlated with survival time (r=0. 833, P<0. 001).

CONCLUSION: The Tokuhashi revised score could support decision making with reliable estimation of life expectancy of patients with spinal metastases. Surgery could be a better choice to extend life span for those patients with solitary spinal metastasis of slow-growth primary tumor and those with the Tokuhashi revised score of 12 to 15 points.