Six parameters were employed in the assessment system. Tokuhashi score, tomita score, baur score, linden score, rades score, and katagiri score were introduced. Modified score based on revised tokuhashi score is needed for the. The value of postural reduction in the initial management of closed injuries of the. Percutaneous vertebroplasty relieves pain in cervical. These findings suggest that the tokuhashi scoring system is the most suitable for identifying patients who should be assessed for curative surgical intervention. Would you allow us to collect statistic data about the use of the website. This score consists of the sum of 6 parameters that are used to measure the severity of the disorder. Prognostic scoring system for metastatic spine tumors. Contemporary treatment strategy for spinal metastasis.
However, a lack of correlation between the revised tokuhashi score and the survival period has been reported for patients with spinal metastases of lung cancer 2426. Tokuhashi et al formulated a prognostic scoring system with a total sum of 12 points for preoperative prediction of life expectancy in 1990 and revised it in 2005 to a total sum of 15 points. The tokuhashi scoring system ts is a survival prediction in patients with spinal metastasis. Research on the predicting power of the revised tokuhashi. Survival is a key factor physicians consider when selecting a treatment modality for the treatment of spinal metastases.
The modified tokuhashi scoring system and the tomita scoring system are internationally validated preoperative scoring systems to predict survival of mscc patients, they were developed to maximize the chance of neurological recovery and ambulatory status, and to avoid unnecessary surgical procedures in patients with poor prognosis. C overall survival for the adjusted and regrouped scoring systems. We used a scoring system for the preoperative evaluation of the prognosis of metastatic spinal tumors and selected treatment methods for the predicted prognosis. Prediction of survival in patients with metastases in the. The karnofsky scoring system is widely used for prognosis of central nervous system tumors. Revised tokuhashi evaluation system for the prognosis of metastatic spine tumours. Ssg scoring, however, was suitable for identifying patients expected to survive for score 9 11. Thus, this study was conducted to identify the prognostic effect of factors involved in revised tokuhashi score rts. We aimed to assess whether a revision of the tr2005 can improve the prognostic. The prediction of survival plays a key role in choosing therapeutic modality, and tokuhashi score was established as one of the most commonly used predictive systems for spinal metastases.
Surgical intervention for vertebral metastases may benefit. Metastatic cancer is the most common reason for a destructive bone lesion in adults. Metastatic disease of spine pathology orthobullets. Evaluation of scoring systems and prognostic factors in patients with spinal metastases from nasopharyngeal carcinoma naresh kumar, jonathan tan, aye sandar zaw, khin lay wai national university health system singapore.
Estimated survival curves of the tokuhashi scoring systems. Analysis of four scoring systems for the prognosis of. A score between 0 and 8 indicates a predicted survival period less than 6 months with a suggestion of conservative or palliative treatment, while 911 and 1215 correspond to a predicted. Pdf tokuhashi scoring system has limited applicability. Scoring system for prediction of metastatic spine tumor.
Studies have reported good interobserver agreement among both radiologists and radiation oncologists in using the score 1,2. Tokuhashi et al revised the system for diverse tumours types in 2005. Classification and scoring systems for metastatic spine tumors. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. The tokuhashi scoring system detected the highest survival at 6 months 88.
To evaluate the accuracy of a revised scoring system predicting metastatic spinal tumor prognosis and the suitability of the subsequent treatment strategy. Accuracy of the revised tokuhashi score in predicting survival in patients with metastatic. Their rationale for developing a new score was that the tokuhashi score distinguishes only two treatment options, excisional and palliative surgery. Tokuhashi score and other prognostic factors in 260. Classification, evaluation, and scoring systems for metastatic spine tumors reported to date were identified by performing a literature search on pubmed. For patients with total ts of 8 or less points, ts predicts a survival of 6 months or less. Classification and scoring systems for metastatic spine. This scoring system was later revised to take into account the strong influence of primary tumour type on survival by scoring this parameter on a maximum of 5 points 12. The tokuhashi revised score from 2005 tr2005 is the most recommended prognostic scoring system in patients with metastatic spinal cord compression mscc. To evaluate the accuracy of a revised scoring system predicting. Survival analysis of malignant epidural spinal cord. Survival analysis of malignant epidural spinal cord compression after palliative radiotherapy using tokuhashi scoring system and the impact of systemic therapy. Spine 2005, 30 19, 21862191 with permission from lippincott williams and wilkins publishers.
Since the score of each item of the original tokuhashi scoring system lacked weighting, each factor of each item was weighted by cox hazard analysis in the new scoring system. At the time of treatment, the data necessary to complete tss may be incomplete, making its application impossible. Both scoring systems separately have incapacity for determination of the clinical status of the patients. Predictive value of tokuhashi scoring systems in spinal. The thoracolumbar injury classification and severity score tlics, also sometimes known as the thoracolumbar injury severity score tiss, was developed by the spine trauma group in 2005 to overcome some of the perceived difficulties regarding the use of other thoracolumbar spinal fracture classification systems for determining treatment 1. Scoring system for prediction of metastatic spine tumor prognosis. An assessment system for the prognosis of metastatic spine tumors was evaluated for 64 cases who had undergone surgery. Prognostic effect of factors involved in revised tokuhashi score. The scoring consists of six parameters including general condition, number of extraspinal bony metastases, number of vertebral metastases, number of visceral metastases, primary site of cancer, and spinal cord palsy. It has been shown to useful in guiding the mobilization or operative management of patients with neoplastic spinal disease. These papers have become landmark articles concerning prognostic scoring systems for patients with metastatic spinal tumors. Patients with a life expectancy of 6 months benefited from tumor excision and reconstruction.
In 1998, tokuhashi, et al, modified this scoring system by diversifying the tumor types into six categories. Spinal palsy is a prognostic parameter in the tokuhashi scoring system but not in the tomita scoring system. A revised scoring system for preoperative evaluation of. These findings suggest that the tokuhashi scoring system is the most suitable for identifying patients who should be assessed for curative surgical. In the univariate analyses, sex, the patients general condition, the presenceabsence of major internal organ metastasis, the total revised tokuhashi score, the serum albumin level, childpugh class, spinal surgery, and bonemodifying agent bma treatment were found to influence the posttreatment survival time. Tokuhashi score metastatic spine tumor prognosis general condition karnofsky 0 points. The data is anonymous and not connected to any specific user. This system was reported by tokuhashi et al in 1989 as a.
Prior to selecting a scoring system to predict prognosis, it is important to. Pdf scoring system for prediction of metastatic spine tumor. Tokuhashi scoring system has limited applicability in the. We used to use the tokuhashi scoring system, which we developed, to determine the optimal treatment strategy for lung cancer patients with metastatic spine tumors. However, it has been reported that images are not easy to evaluate and that the kappa values of inter or intraobserver agreement are not necessarily high. A service of the national library of medicine, national institutes of. In lung cancer patients, the maximum total tokuhashi score is 10 points, and it is difficult to predict a life expectancy of. The concordance rate between the prognostic predictions based on the revised tokuhashi score and the patients actual survival times 69. The tokuhashi scoring system tss is a widely used prognostic tool. However, recent studies have questioned its prognostic ability and the need for a new revision has been proposed. Spinal instability neoplastic score sins radiology. A study of the predictive value of the modified tokuhashi. They are all scoring systems prepared by combining.
A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis metastatic spinal cord compression your browsing activity is empty. Review article managementofmetastaticcervical spine tumors abstract the skeletal system is the third most common site of metastases after the lung and liver. Prognostic effect of factors involved in revised tokuhashi. To evaluate the number of tss scores completed by the time the clinical therapeutic decision was made. Within the skeletal system, the vertebral column is the most common site of metastases, and 8% to 15% of vertebral metastases are in the cervical spine, consisting. The spinal instability neoplastic score sins helps to assess tumor related instability of the vertebral column. Comparison of prognostic scores and surgical approaches to. This study aims to compare kps and ts for life expectancy in palliative patients with spinal. This scoring system was later revised to take into account the strong influence of primary tumour type on survival by scoring this parameter on a maximum of 5 points. A comparison of the modified tokuhashi and tomita scores in. Evaluation of scoring systems and prognostic factors in.
Prognostic factors in patients with metastatic spine. Pdf accuracy of the revised tokuhashi score in predicting survival. Therefore, caution must be exercised in the comparative evaluation of the score among examiners and hospitals10. Tokuhashi score is one of the most popularly used score systems for spinal metastases and most commonly reported in literature, which was. Tokuhashi scoring system has limited applicability in the majority of patients with spinal cord compression secondary to vertebral metastasis. The revised tokuhashi score is a prognostic scoring systems for spinal metastases. Preoperative palsy score has no significant association. Pdf purpose the revised tokuhashi score has been widely used to. Thoracolumbar injury classification and severity score. Ssg scoring, however, was suitable for identifying patients expected to survive for 6 months 91. Survival is predicted by several prognostic scoring systems, such as the revised tokuhashi score rts 3, tomita score 4, and bauer score. Scoring systems tokuhashi score this system was reported by tokuhashi et al in 1989 as a scoring system for the preoperative evaluation of a patients prognosis with a metastatic spinal tumor. Analysis of the predictive role and new proposal for. In this cohort, the revised tokuhashi system gave the best approximation for survival, with a mean predictive capability 60.
Pdf evaluation of prognostic scoring systems for bone. Spine instability neoplastic score sins sins is used to assess the stability of the spine in patients with metastatic spinal cord compression it has near perfect inter and intraobserver reliability in determining three clinically relevant categories of stability. Paralysis, which was considered not to affect the survival period, was excluded, and the new scoring system was simplified compared with tokuhashis. However, the use of both scoring systems is most appropriate when determining treatment for spinal metastasis, especially when considering surgery. A overall survival for the original tokuhashi scoring system. Various assessment systems can predict length of survival and facilitate selection of the most appropriate treatment. Review article managementofmetastaticcervical spine tumors. Two investigators independently retrieved relevant literature on platforms of pubmed, embase and cochrane.
The revised tokuhashi is the only scoring system to clearly define both predicted prognosis and treatment strategy for those seeking to evaluate their own patients. There is a lack of knowledge about the specific predictive value of those scoring systems in patients with spinal metastases from a variety of cancer groups. B regrouping into score groups of 05, 69, and 1015 based on the survival data. Full article pdf 5 academic content and language evaluation of this article citation of this article corresponding author of this article publishing process of this article. In the revised tokuhashi scoring system, lung cancer is assigned 0 points, giving a low score to a lung cancer patient with frankel c palsy. Therefore, tokuhashi et al6 developed a simple scoring system for the preoperative evaluation of the prognosis for patients with spinal metastases. In the previous version of our scoring system, the reliability of the predicting prognosis was 63. Modified tokuhashi scoring system score from 015 is used to evaluate the prognosis of metastatic spinal tumors and selected treatment methods.
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