Prognosis Scores of Tokuhashi and Tomita for Patients With Spinal Metastases of Renal Cancer

Ulmar, Benjamin; Naumann, Ulrike; Catalkaya, Sibel; Muche, Rainer; Cakir, Balkan; Schmidt, René; Reichel, Heiko; Huch, Klaus

doi:10.1245/s10434-006-9000-5

Cited by 60 publications

(30 citation statements)

References 27 publications

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“…Complication rates in the aforementioned surgery studies ranged from 16% to 65%. 7,11,13,19,26,32 The rate of major complications in the present series was 30%, and these complications included respiratory failure requiring reintubation, septic shock and multiple system organ failure, hospital-acquired pneumonia, rapid tumor growth leading to further neurological compromise, venous thrombosis requiring anticoagulation, pulmonary embolus, hyponatremia and delirium, and wound infection and dehiscence. Most complications following surgery for RCC-derived spinal metastases are related to thromboembolic events or to infectious complications such as pneumonia, urinary tract infection, or wound breakdown.…”

Section: Discussionmentioning

confidence: 68%

Factors associated with improved survival following surgery for renal cell carcinoma spinal metastases

Petteys

Spitz

Goodwin

et al. 2016

FOC

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OBJECTIVE Renal cell carcinoma (RCC) frequently metastasizes to the spine, causing pain or neurological dysfunction, and is often resistant to standard therapies. Spinal surgery is frequently required, but may result in high morbidity rates. The authors sought to identify prognostic factors and determine clinical outcomes in patients undergoing surgery for RCC spinal metastases. METHODS The authors searched the records of patients who had undergone spinal surgery for metastatic disease at a single institution during a 12-year period and retrieved data for 30 patients with metastatic RCC. The records were retrospectively reviewed for data on preoperative conditions, treatment, and survival. Statistical analyses (i.e., Kaplan-Meier survival analysis and log-rank test in univariate analysis) were performed with R version 2.15.2. RESULTS The 30 patients (23 men and 7 women with a mean age of 57.6 years [range 29–79 years]) had in total 40 spinal surgeries for metastatic RCC. The indications for surgery included pain (70%) and weakness (30%). Fourteen patients (47%) had a Spinal Instability Neoplastic Score (SINS) indicating indeterminate or impending instability, and 6 patients (20%) had a SINS denoting instability. The median length of postoperative survival estimated with Kaplan-Meier analysis was 11.4 months. Younger age (p = 0.001) and disease control at the primary site (p = 0.005), were both significantly associated with improved survival. In contrast, visceral (p = 0.002) and osseous (p = 0.009) metastases, nonambulatory status (p = 0.001), and major comorbidities (p = 0.015) were all significantly associated with decreased survival. Postoperative Frankel grades were the same or had improved in 78% of patients. Major complications occurred in 9 patients, and there were 3 deaths (10%) during the 30-day in-hospital period. Three en bloc resections were performed. CONCLUSIONS Resection and fixation may provide pain relief and neurological stabilization in patients with spinal metastases arising from RCC, but surgical morbidity rates remain high. Younger patients with solitary spinal metastases, good neurological function, and limited major comorbidities may have longer survival and may benefit from aggressive intervention.

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Section: Discussionmentioning

confidence: 68%

Factors associated with improved survival following surgery for renal cell carcinoma spinal metastases

Petteys

Spitz

Goodwin

et al. 2016

FOC

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“…According to their study, the Tokuhashi score was more valuable than the Tomita score for predicting survival. 8 We believe that including all primary sites is more representative of the true clinical use of the scores, which are used to determine prognosis of all patients afflicted with spinal metastasis, irrespective of primary site. In addition, the modified Tokuhashi score included more primary site divisions as part of their prognosis parameters.…”

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confidence: 99%

A comparison of the modified Tokuhashi and Tomita scores in determining prognosis for patients afflicted with spinal metastasis

Aoude

Amiot

2014

Can J Surg

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“…O comprometimento vertebral nas metástases e no MM prejudicam não só a função mecânica de sustentação da coluna, mas também a qualidade de vida destes pacientes, em decorrência da presença de quadro doloroso ou da lesão neurológica associada 1,3,[5][6][7][8][9][10] . A correlação entre a taxa de sobrevida e estes índices é contestada por muitos autores, e sua aplicabilidade para o MM ainda não foi avaliada 6,[13][14][15][16] . Em virtude da semelhança de comportamento, história natural e de tratamento entre os portadores de metástase e MM na coluna, estudamos a aplicabilidade destes índices nos portadores de fratura patológica por MM na coluna.…”

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Fratura na coluna vertebral por mieloma múltiplo: correlação entre sobrevida e índices de Tomita e Tokuhashi

Avanzi¹,

Landim²,

Meves³

et al. 2009

Coluna/Columna

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Prognosis Scores of Tokuhashi and Tomita for Patients With Spinal Metastases of Renal Cancer

Abstract: For surgical decisions in renal cancer patients with spinal metastases, the prognostic score of Tokuhashi appears to be much more valuable than the Tomita score.

Cited by 60 publications

References 27 publications

Factors associated with improved survival following surgery for renal cell carcinoma spinal metastases

Factors associated with improved survival following surgery for renal cell carcinoma spinal metastases

A comparison of the modified Tokuhashi and Tomita scores in determining prognosis for patients afflicted with spinal metastasis

Fratura na coluna vertebral por mieloma múltiplo: correlação entre sobrevida e índices de Tomita e Tokuhashi

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