A revision of the Tokuhashi revised score improves the prognostic ability in patients with metastatic spinal cord compression
A revision of the Tokuhashi revised score improves the prognostic ability in patients with metastatic spinal cord compression
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DOI：
10.1007/s00432-017-2519-y
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发表时间：
2018-01-01
影响因子：
3.6
通讯作者：
Dahl, Benny
中科院分区：
文献类型：
--
作者：
Morgen, Soren Schmidt;Fruergaard, Sidsel;Dahl, Benny
2005年Tokuhashi修订评分（TR 2005）是转移性脊髓压迫（MSCC）患者最推荐的预后评分系统。然而，最近的研究质疑其预后能力，并提出了新的修订的必要性。我们的目的是评估TR 2005的修订是否可以提高评分系统的预后能力。在2011年和2012年，共有1143例连续的MSCC患者被前瞻性纳入2011年和2012年的队列。对于2011年入院的患者（n = 544），分析了TR 2005的组成部分（包括原发性癌症诊断）的预后能力。基于这些发现，将TR 2005评分的修订版定义为Tokuhashi修订评分2017（TR 2017）。采用Kaplan Meyer（KM）曲线比较TR 2005和TR 2017的预后能力，并对2012年收治的599例患者进行受试者工作特征（ROC）分析，KM曲线和ROC分析显示TR 2017的预后能力优于TR 2005。ROC面积如下：< 6个月生存期，TR 2017 = 0.71和TR 2005 = 0.65，p = 0.003; 6个月生存期，TR 2017 = 0.71和TR 2005 = 0.65，p = 0.003; 12个月生存率TR 2017 = 0.72和TR 2005 = 0.67，p = 0.0015。TR 2017可以提高TR 2005对MSCC患者的预后能力。这可能会影响MSCC患者的术前评估。
The Tokuhashi revised score from 2005 (TR2005) is the most recommended prognostic scoring system in patients with metastatic spinal cord compression (MSCC). However, recent studies have questioned its prognostic ability and the need for a new revision has been proposed. We aimed to assess whether a revision of the TR2005 can improve the prognostic ability of the scoring system.In 2011 and 2012, a total of 1143 consecutive patients admitted with MSCC were prospectively included in a 2011 and a 2012 cohort. For the patients admitted in 2011 (n = 544), the components of the TR2005 including primary cancer diagnosis were analyzed regarding the prognostic ability. Based on these findings, a revision of the TR2005 score was defined as the Tokuhashi revised score 2017 (TR2017). The prognostic abilities of the TR2005 and the TR2017 were compared by Kaplan Meyer (KM) curves, and receiver-operating characteristics' (ROC) analysis was compared in a cohort of patients admitted in 2012 (n = 599).KM curves and ROC analysis showed that the TR2017 had better prognostic ability compared to the TR2005. The ROC areas were as follows: < 6-months survival, TR2017 = 0.71 and TR2005 = 0.65, and p = 0.003; for 6-month survival, TR2017 = 0.71 and TR2005 = 0.65, and p = 0.003; for 12-month survival TR2017 = 0.72 and TR2005 = 0.67, and p = 0.0015.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.