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World J Orthop. Jul 18, 2014; 5(3): 262-271
Published online Jul 18, 2014. doi: 10.5312/wjo.v5.i3.262
Scoring system for prediction of metastatic spine tumor prognosis
Yasuaki Tokuhashi, Hiroshi Uei, Masashi Oshima, Yasumitsu Ajiro
Yasuaki Tokuhashi, Hiroshi Uei, Masashi Oshima, Department of Orthopaedic Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan
Yasumitsu Ajiro, Department of Orthopaedic Surgery, Surugadai Nihon University Hospital, Chiyoda-ku, Tokyo 101-8309, Japan
Author contributions: Tokuhashi Y performed the literature review, drafted the article; Uei H and Oshima M helped in the literature review, revised the article critically for important intellectual content; Ajiro Y helped in the literature review, making tables, checked references; all finally approved for print.
Correspondence to: Yasuaki Tokuhashi, MD, Professor, Department of Orthopaedic Surgery, Nihon University School of Medicine, 30-1 Oyaguchi-kamicho, Itabashi-ku, Tokyo 173-8610 Japan. tokuhashi.yasuaki@nihon-u.ac.jp
Telephone: +81-33972-8111 Fax: +81-33972-8201
Received: December 20, 2013
Revised: March 24, 2014
Accepted: May 15, 2014
Published online: July 18, 2014
Processing time: 211 Days and 5.2 Hours
Abstract

Assessing the prognosis before treatment for metastatic spine tumor is extremely important in therapy selection. Therefore, we review some prognostic scoring systems and their outcomes. Articles with combinations of two keywords among “metastatic spine tumor” and “prognosis”, “score”, “scoring system”, “predicting”, or “life expectancy” were searched for in PubMed. As a result, 236 articles were extracted. Those referring to representative scoring systems about predicting the survival of patients with metastatic spine tumors were used. The significance and limits of these scoring systems, and the future perspectives were described. Tokuhashi score, Tomita score, Baur score, Linden score, Rades score, and Katagiri score were introduced. They are all scoring systems prepared by combining factors that affect prognosis. The primary site of cancer and visceral metastasis were common factors in all of these scoring systems. Other factors selected to influence the prognosis varied. They were useful to roughly predict the survival period, such as, “more than one year or not” or “more than six months or not”. In particular, they were utilized for decision-making about operative indications and avoidance of excessive medical treatment. Because the function depended on the survival period in the patients with metastatic spine tumor, it was also utilized in assessing functional prognosis. However, no scoring system had more than 90% consistency between the predicted and actual survival periods. Future perspectives should adopt more oncological viewpoints with adjustment of the process of treatment for metastatic spine tumor.

Keywords: Metastatic spine tumo; Prognosis evaluation system; Surgical indication; Treatment modality; Decision-making

Core tip: Some representative scoring systems for the prediction of metastatic spine tumor outcome were reviewed. Tokuhashi score, Tomita score, and others were introduced. They were useful to roughly predict the survival period, and were utilized for the purpose of decision-making about operative indications and the avoidance of excessive medical treatment. While the function in the patients was associated with the survival period, it was also useful to assess functional prognosis. However, no scoring system had more than 90% consistency between the predicted and actual survival periods. They also need a stronger oncological perspective with adjustment of the process of treatment.