Prime

Type your tag names separated by a space and hit enter

A study investigating the validity of modified Tokuhashi score to decide surgical intervention in patients with metastatic spinal cancer.

Abstract

PURPOSE

Predicted survival of a patient is the most important parameter that helps to guide the treatment of a patient with metastatic spinal cancer. We aimed to investigate the reliability of modified Tokuhashi score in the decision-making process in patients with metastatic spinal cancer.

METHODS

We performed a review of our prospectively collected Metastatic Cancer Database over a period of 4 years (2007-2010). Ninety consecutive patients who were treated for metastatic spinal cancer were enrolled. Data review included demographic details, source of primary cancer, duration of symptoms, location of metastases, calculated Karnofsky's performance status, and calculated survival based on modified Tokuhashi score. We divided the patients into 3 groups. Group A included patients with expected survival less than 6 months. Group B included patients with expected survival between 6 and 12 months. Group C included patients whose expected survival was more than 12 months. We compared the calculated expected survival to the actual survival in all three groups with all patients following up to a minimum of 1 year or until death. Statistical analysis was done by Chi-square test and the Fisher Exact test.

RESULTS

The survival prediction in group C was significantly accurate in 80.9 % patients (P = 0.027). However, in groups A and B, only 36.1 and 9.1 % patients survived, respectively, as per predicted. (P > 0.05).

CONCLUSIONS

We can conclude from this study that, when used alone, modified Tokuhashi score may not be a reliable tool to predict survival in all patient groups.

Links

  • PMC Free PDF
  • PMC Free Full Text
  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Royal Derby Hospital, Derby, UK. gul34@yahoo.com

    , , ,

    Source

    MeSH

    Adult
    Aged
    Aged, 80 and over
    Decision Making
    Female
    Humans
    Karnofsky Performance Status
    Male
    Middle Aged
    Prognosis
    Retrospective Studies
    Spinal Neoplasms
    Spine
    Survival Rate

    Pub Type(s)

    Journal Article
    Validation Studies

    Language

    eng

    PubMed ID

    22899107

    Citation

    TY - JOUR T1 - A study investigating the validity of modified Tokuhashi score to decide surgical intervention in patients with metastatic spinal cancer. AU - Gakhar,Harinder, AU - Swamy,Girish N, AU - Bommireddy,Rajendranath, AU - Calthorpe,Denis, AU - Klezl,Zdenek, Y1 - 2012/08/17/ PY - 2012/03/05/received PY - 2012/08/05/accepted PY - 2012/07/23/revised PY - 2012/8/18/entrez PY - 2012/8/18/pubmed PY - 2013/8/27/medline SP - 565 EP - 8 JF - European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society JO - Eur Spine J VL - 22 IS - 3 N2 - PURPOSE: Predicted survival of a patient is the most important parameter that helps to guide the treatment of a patient with metastatic spinal cancer. We aimed to investigate the reliability of modified Tokuhashi score in the decision-making process in patients with metastatic spinal cancer. METHODS: We performed a review of our prospectively collected Metastatic Cancer Database over a period of 4 years (2007-2010). Ninety consecutive patients who were treated for metastatic spinal cancer were enrolled. Data review included demographic details, source of primary cancer, duration of symptoms, location of metastases, calculated Karnofsky's performance status, and calculated survival based on modified Tokuhashi score. We divided the patients into 3 groups. Group A included patients with expected survival less than 6 months. Group B included patients with expected survival between 6 and 12 months. Group C included patients whose expected survival was more than 12 months. We compared the calculated expected survival to the actual survival in all three groups with all patients following up to a minimum of 1 year or until death. Statistical analysis was done by Chi-square test and the Fisher Exact test. RESULTS: The survival prediction in group C was significantly accurate in 80.9 % patients (P = 0.027). However, in groups A and B, only 36.1 and 9.1 % patients survived, respectively, as per predicted. (P > 0.05). CONCLUSIONS: We can conclude from this study that, when used alone, modified Tokuhashi score may not be a reliable tool to predict survival in all patient groups. SN - 1432-0932 UR - https://www.unboundmedicine.com/medline/citation/22899107/full_citation/A_study_investigating_the_validity_of_modified_Tokuhashi_score_to_decide_surgical_intervention_in_patients_with_metastatic_spinal_cancer_ L2 - https://doi.org/10.1007/s00586-012-2480-z ER -