The revised Tokuhashi score; analysis of parameters and assessment of its accuracy in determining survival in patients afflicted with spinal metastasis
The revised Tokuhashi score; analysis of parameters and assessment of its accuracy in determining survival in patients afflicted with spinal metastasis
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DOI：
10.1007/s00586-016-4921-6
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发表时间：
2018-04-01
影响因子：
2.8
通讯作者：
Jarzem, P.
中科院分区：
文献类型：
--
作者：
Aoude, A.;Fortin, M.;Jarzem, P.
目的确定修订的德桥评分的每个参数的意义，并确定哪些参数与生存有关。脊柱转移瘤很常见，可能是一个具有挑战性的医学问题。治疗方案取决于患者的预后。文献中的许多评分系统都有助于估计预后，如Tokuhashi评分系统、修订的Tokuhashi评分系统和Tomita评分系统。方法对2003-2012年间同一中心收治的所有脊柱转移瘤患者进行回顾性分析。检查影像、病理和图表以确定改良的德桥评分。然后将得分与实际记录的存活率进行比较。使用单变量和多元回归分析来评估每个个体参数和生存时间的重要性。采用线性回归分析方法，分析Tokuhashi评分和加权Tokuhashi评分与生存时间的关系。单变量分析显示，除原发部位外，修订的Tokuhashi评分中的所有参数均与生存时间显著相关。在多因素分析中，只有脊柱转移数和主要器官转移数有统计学意义。结论脊柱转移数和主要器官转移数是影响患者实际生存的最重要因素。根据人群特征修改评分将有助于更好地识别可以从手术中受益的脊柱转移患者。
Purpose To determine the significance of each parameter of the revised Tokuhashi score and identify which is associated with survival.Background Spinal metastases are common and can be a challenging medical issue. Treatment options depend on patients' prognosis. Many scoring systems in the literature help estimate prognosis, such as the Tokuhashi, revised Tokuhashi, and Tomita scoring systems.Methods A retrospective review of all patients from 2003 to 2012 treated for spinal metastases in one center was conducted. Imaging, pathology, and charts were reviewed to determine the modified Tokuhashi scores. Scores were then compared to the actual documented survival. Univariate and multiple regression analyses were used to assess the importance of each individual parameter and survival time. Linear regression was used to determine the relationship between the Tokuhashi score and weighted Tokuhashi score with survival time.Results A total of 126 patients were reviewed. All parameters in the revised Tokuhashi score were significantly associated with survival time except for primary site using univariate analysis. Only the number of spinal metastases and metastasis to major organs showed statistical significance when multiple variable analysis was used.Conclusion A number of spinal metastases and metastasis to major organs were the most important predictors of actual survival. Modification to the score based on population characteristics would help better identify patients with spinal metastases that can benefit from surgery.