Abstract
ABSTRACT Objective: The objective of this study is to present demographic data on the occurrence of spinal metastases in the service where the work was performed and to investigate the reliability of the modified Tokuhashi score in the decision making in patients with metastatic spinal cancer. Methods: We conducted a review of medical records of all cases of vertebral bone metastasis, confirmed by anatomopathological examination, from January 2009 to June 2012. Data review included demographic details, origin of the primary cancer, duration of symptoms, localization of metastases, Karnofsky performance scale and survival based on modified Tokuhashi score. We divided patients into three groups. Group A included patients with life expectancy of less than six months, group B included patients with life expectancy of between six and 12 months, and group C included patients with a life expectancy of more than 12 months. We compared the calculated survival with the current survival in the three groups with all patients followed-up to a minimum of 1 year or until death. Results: The predict survival in group A was 63.6% according to the modified Tokuhashi score, albeit group B had only 30% agreement. Conclusions: For patients in group A, the agreement rate of patient survival was better (63.4%) than that observed in patients in group B (30%). Our sample had no patient classified as group C.
Highlights
Bone metastases are the most common skeletal tumors and the spine is the most common site of bone involvement
The objective of this study is to present demographic data about the occurrence of spinal metastases in the service where the study was conducted and to investigate the reliability of the modified Tokuhashi score in the decision-making process in patients with metastatic spinal cancer
In Tokuhashi’s original article and in that where he presents the modified score, lymphoma and myeloma were excluded as causes of bone metastasis
Summary
Bone metastases are the most common skeletal tumors and the spine is the most common site of bone involvement. Skeletal metastases are produced by almost all forms of malignant disease, but they are most often secondary to breast, lung, and prostate cancer, and less frequently to kidney, thyroid, and gastrointestinal cancer. Lymphoreticular neoplasms, breast, lung and prostate account for approximately 60% of all vertebral tumors. Vertebral metastasis should be considered a systemic disease with limited treatment methods. The spine surgeon with oncological knowledge should be able to prevent recurrence of the tumor, avoid neurological damage, and, above all, contribute to the quality of life of the patient until the last moment of life. It is important to determine the mode of treatment according to the survival of the patient. Non-surgical treatment is still an important option, surgical treatment with all its modalities should be considered
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
