Prognostic evaluation of patients with metastatic spinal tumors using modified Tokuhashi's score: A retrospective study

Abstract

Introduction: Tokuhashi's scoring has been used as a presurgical tool for prediction of survival in patients with spinal metastases (SM). It evaluates prognostic factors such as performance status, number of extraspinal bone metastasis, metastasis to visceral organs, site of primary, and neurological status that determine the survival in these patients. To the best of our knowledge, only limited studies are available to use this scoring system to determine survival outcomes in patients with SMs undergoing palliative radiotherapy. Aim: The purpose of our study was to determine the patient characteristics and usefulness of modified Tokuhashi's score in determining survival in patients with SM. Methods: This is a retrospective study of patients who underwent radiotherapy for SM from January 2013 to December 2017. Results: Seventy patients with SM from solid tumors were included in the study. The male to female ratio was 1.3:1. The median ageat diagnosis of SM was 50 years. The median survival was 7 months. The modified Tokuhashi's score ranged from 0 to 13, and the mean score was 6. In our study, 46 belonged to the poor prognostic group, 20 belonged to the moderate prognostic group, and 4 patients belongedto good prognostic group with a median survival of 4.8, 13.5, and 28 months, respectively. There was a statistical significance in the difference in survival in three prognostic groups. Conclusion: Our study confirms the usefulness of modified Tokuhashi's score in determining the survival outcomes in patients with metastatic spinal tumors.