To Explore The Clinical Value Of The New England Spinal Metastatic Tumor Scoring System

Objective: By comparing the predicted and actual survival time of patients undergoing spinal metastatic tumor surgery,and comparing it with two commonly used scoring systems,the revised Tokuhashi scoring system and the Tomita scoring system.We can evaluate the pratical value of the New England Spinal Metastasis Score(NESMS).It provides reference for clinicians to formulate strategies for patients with spinal metastases.Methods: We Use three prognostic scoring systems,the revised Tokuhashi score,Tomita score and NESMS score,to retrospectively score 202 patients with spinal metastases and predict their survival time.Univariate and multivariate Cox proportional risk regression models were constructed to evaluate the association between clinical characteristics of the inclusion score and survival time.The consistency test Kappa value was used to evaluate the consistency between the prediction of survival rate of patients with spinal metastatic tumor and the actual survival rate.Results: Multivariate Cox proportional risk regression model analysis found that the systemic condition([HR]0.6,[95%CI]:0.452--0.797,P < 0.001),visceral metastasis([HR]0.725,[95%CI]:0.606-0.869,P < 0.001),primary tumor site([HR]0.835,[95%CI]:0.762--0.914,P < 0.001),and serum albumin level([HR]0.634,[95%CI]:0.440--0.914,P =0.015)were closely correlated with the survival time of patients with spinal metastases.An independent factor for survival time.In this study,the consistency between the three scoring systems in predicting the survival time of patients with spinal metastatic tumor and the actual survival time was different,and NESMS showed the best performance(Kappa=0.759)with good consistency.The revised Tokuhashi score followed(Kappa=0.411),showing good consistency.Tomita had the lowest score(Kappa=0.229)with poor consistency.Conclusion: As a reference index for predicting the survival prognosis of patients with spinal metastases,NESMS scoring system has a higher prediction consistency than the other two commonly used prediction systems.It can be accepted by spinal surgeons as a reference for the treatment choice of patients with spinal metastases.