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| GONG Yining,HU Jinxin,WEI Feng.The accuracy of Tomita score and revised Tokuhashi score in predicting postoperative survival of patients with spinal metastases in the past decade[J].Chinese Journal of Spine and Spinal Cord,2021,(2):97-102. |
| The accuracy of Tomita score and revised Tokuhashi score in predicting postoperative survival of patients with spinal metastases in the past decade |
| Received:September 30, 2020 Revised:November 13, 2020 |
| English Keywords:Spinal metastases Tomita score Revised Tokuhashi score Survival prediction |
| Fund:北京大学第三医院资助项目（编号：Y71508-01） |
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| English Abstract: |
| 【Abstract】 Objectives: To analyze the accuracy of Tomita score and revised Tokuhashi score in predicting the postoperative survival of patients with spinal metastases in the past decade. Methods: A retrospective analysis of patients who underwent initial surgery for spinal metastases at Peking University Third Hospital between March 2010 and July 2019 was conducted. Follow-up time was no less than 12 months or until the patients′ death. Overall survival time of all patients and patients with the five common pathological types (lung, renal, breast, thyroid, and prostate cancer) was analyzed through Kaplan-Meier analysis, and a log-rank test was used to compare the Tomita scores and the revised Tokuhashi scores between different groups. By comparing the actual survival time of patients with the survival time predicted by the Tomita score and the revised Tokuhashi score, the prediction accuracy of these two scores in different groups and the above five pathological types was calculated. Results: A total of 221 patients were included in the study, with 94 patients (42.5%) who survived at final follow-up. The median survival time of the included patients was 27.0 months (95%CI: 22.1-31.9 months), and the 1-year survival rate was 67.4%. The median survival time of patients with Tomita scores of 2-3, 4-5, 6-7 and 8-10 points were 34.0 months(95%CI: 22.3-45.7 months), 41.0 months (95%CI: 19.1-62.9 months), 16.0 months (95%CI: 5.2-26.8 months), and 12.0 months (95%CI: 2.1-21.9 months)(P<0.001), respectively. The median survival time of patients with revised Tokuhashi scores of 0-8, 9-11 and 12-15 points were 18.0 months (95%CI: 11.6-24.4 months), 30.0 months (95%CI: 16.2-43.8 months) and 51.0 months (95%CI: 33.2-68.8 months) (P<0.001), respectively. In all patients, the Tomita score can accurately predict the survival time of 30.2% (57/189) patients, and the revised Tokuhashi score can accurately predict the survival time of 32.6%(72/221) patients. Prediction accuracy greater than 50% was only in Tomita score 2-3 points and revised Tokuhashi score 12-15 points. Among the five common pathological types, Tomita score had relatively good prediction accuracy for breast cancer(43.5%) and revised Tokuhashi score for thyroid cancer (56.3%). The prediction accuracy of lung cancer was the worst, with Tomita score and revised Tokuhashi score of 22.2% and 26.3%, respectively. Conclusions: Tomita score and revised Tokuhashi score can still distinguish patients with different survival time grades. However, the actual survival time of patients with different grades has greatly improved. It is still not satisfied with the accuracy of individual survival prediction, especially for patients with lung cancer metastases. |
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