A revision of the Tokuhashi revised score improves the prognostic ability in patients with metastatic spinal cord compression

Morgen, Søren Schmidt; Fruergaard, Sidsel; Gehrchen, Martin; Bjørck, Sebastian; Engelholm, Svend Aage; Dahl, Benny

doi:10.1007/s00432-017-2519-y

Cited by 27 publications

(16 citation statements)

References 17 publications

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“…However, due to their rarity, most of these studies were based on small sample size in one single tumor center, and their epidemiological features are not well known. In addition, although many score systems of spine metastasis have been constructed, few of them can be applied in PSMs (10)(11)(12). Thus, their clinical features and predictors should be identified by a large cohort of patients and advanced modeling methods should also be used to establish a well-applied prediction model.…”

Section: Introductionmentioning

confidence: 99%

The Clinical Characteristics and Prediction Nomograms for Primary Spine Malignancies

et al. 2021

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BackgroundPrimary spine malignancies (PSMs) are relatively rare in bone tumors. Due to their rarity, the clinical characteristics and prognostic factors are still ambiguous. In this study, we aim to identify the clinical features and proposed prediction nomograms for patients with PSMs.MethodsPatients diagnosed with PSMs including chordoma, osteosarcoma, chondrosarcoma, Ewing sarcoma, and malignant giant cell tumor of bone (GCTB) between 1975 and 2016 were selected from the Surveillance, Epidemiology, and End Results (SEER) database. The patient and tumor characteristics were described based on clinical information. The significant prognostic factors of overall survival (OS) and cancer-specific survival (CSS) were identified by the univariate and multivariate Cox analysis. Then, the nomograms for OS and CSS were established based on the selected predictors and their accuracy was explored by the Cox–Snell residual plot, area under the curve (AUC) of receiver operator characteristic (ROC) and calibration curve.ResultsThe clinical information of 1,096 patients with PSMs was selected from the SEER database between 1975 and 2016. A total of 395 patients were identified with full survival and treatment data between 2004 and 2016. Chordoma is the commonest tumor with 400 cases, along 172 cases with osteosarcoma, 240 cases with chondrosarcoma, 262 cases with Ewing sarcoma and 22 cases with malignant GCTB. The univariate and multivariate analyses revealed that older age (Age > 60), distant metastasis, chemotherapy, and Surgery were independent predictors for OS and/or CSS. Based on these results, the nomograms were established with a better applicability (AUC for CSS: 0.784; AUC for OS: 0.780).ConclusionsThis study provides the statistics evidence for the clinical characteristics and predictors for patients with PSMs based on a large size population. Additionally, precise prediction nomograms were also established with a well-applicability.

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Section: Introductionmentioning

confidence: 99%

The Clinical Characteristics and Prediction Nomograms for Primary Spine Malignancies

et al. 2021

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“…Prognostic scoring systems were designed to assist the practitioner during the decision-making process, whether a patient should be offered surgical treatment or not [17]. Based on immunohistochemistry, breast cancer was divided into four subtypes.…”

Section: Discussionmentioning

confidence: 99%

Survival of Spinal Metastasis Disease based on Immunohistochemistry Subtype of Breast Cancer: A Systematic Review and Meta-analysis

Hadisaputra

Mahadewa

Mardhika

2021

Open Access Maced J Med Sci

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BACKGROUND: Breast cancer is categorized as a slow-growth tumor in the spinal metastases disease (SMD) scoring system. Based on immunohistochemistry, breast cancer has four subtypes: Luminal A (LumA), luminal B (LumB), human epidermal growth factor 2 (Her-2) type, and triple-negative breast cancer (TNBC). TNBC has the poorest prognosis. AIM: This study aimed to describe the survival time of breast cancer with SMD based on immunohistochemistry subtypes through systematic review and meta-analysis. METHODS: This is a systematic review and meta-analysis study. This study used electronic articles published in PubMed and CENTRAL online database. We used keywords ([breast] AND [cancer] AND [spine] AND [metastasis]) to find eligible studies. Articles included were full-text studies in English. Survival time as the outcome was pooled according to the immunohistochemistry subtype of breast cancer. Statistical analysis was performed using software Stata. RESULTS: Five articles met our inclusion and exclusion criteria. LumA, LumB, Her-2 type, and TNBC have a survival time of 32.84 months, 35.20 months, 60.8 months, and 14.27 months, respectively. CONCLUSION: TNBC has the lowest survival time in the pooled analysis. We proposed TNBC be categorized as a moderate growth primary tumor.

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“…The most commonly used scoring systems are the revised Tokuhashi (8) and the Tomita (11) scoring systems. However, the precision in predicting survival is not optimal (11,12,31,32). Some of the scoring systems were developed one or two decades ago, when surgical treatments were controversial, and radiotherapy and chemotherapy have been improved markedly since then, resulting in improved overall survival (33)(34)(35).…”

Section: Discussionmentioning

confidence: 99%

“…Several pre-operative prognostic scoring systems for patients with MSCC have been developed (6)(7)(8)(9)(10). The conclusions from evaluations are mixed (11)(12)(13)(14) and there is a need for continuously adapting these scoring systems as survival time increases. Based on the collection of data for a decade, we had the unique possibility to study long-term survival among patients with MSCC.…”

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Long-term Survival After Surgical Treatment of Spinal Metastasis – The Predictive Role of Sex

et al. 2020

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Background/Aim: An increasing number of patients undergo surgical treatment for metastatic spinal cord compression (MSCC). However, the possible role of sex as an independent predictor of long-term survival has not been studied. This study aimed to examine whether sex is associated with long-term survival after surgical treatment in patients with MSCC. Patients and Methods: A total of 110 patients were operated on for MSCC from 2005 through 2006. The relation between sex and overall survival was investigated. The followup period was 10 years. Results: Survival time was significantly longer for women compared to men (mean±SD: 29±5.2 vs. 14±3.6 month (p=0.01). With adjusted analysis, this difference remained statistically significant. After adjusting for specific primary tumor type and time since surgery, the hazardratio of 10-year survival for men compared to women was 1.47 (95% confidence intervaI=1. 01-2.18, p=0.048). Conclusion: These findings indicate that sex is associated with long-term survival in patients treated for MSCC.

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A revision of the Tokuhashi revised score improves the prognostic ability in patients with metastatic spinal cord compression

Abstract: The TR2017 can improve the prognostic ability of the TR2005 in patients with MSCC. This could affect the preoperative evaluation of patients suffering from MSCC.

Cited by 27 publications

References 17 publications

The Clinical Characteristics and Prediction Nomograms for Primary Spine Malignancies

The Clinical Characteristics and Prediction Nomograms for Primary Spine Malignancies

Survival of Spinal Metastasis Disease based on Immunohistochemistry Subtype of Breast Cancer: A Systematic Review and Meta-analysis

Long-term Survival After Surgical Treatment of Spinal Metastasis – The Predictive Role of Sex

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