Analysis Of Prognostic Factors In Patients With Spinal Metastases Treated With Modified Tokuhashi Score

Objective:To evaluate the practical value of the modified Tokuhashi scoring system(TS)by comparing the Expected survival time and Real Survival time of patients with spinal metastases.Methods: A retrospective analysis of 108 patients who underwent surgical treatment of spinal metastases in our hospital from Jan 2006 to Dec 2017 was performed.All cases were scored using a modified Tokuhashi score system before surgery and were divided into three groups according to the modified TS scores: TS 0-8,TS 9-11,and TS 12-15,and survival analysis was performed on the three sets of data,and the relationship between factors in the modified TS score system(general condition of the patient,number of extra-spinal bone metastases foci,number of metastases in the vertebral bodies,metastases to the major internal organs,primary site of the cancer,and neurological status),age,gender,and survival time were analyzed.The survival rate was analysed and p < 0.05 was considered statistically significant.Results: In our study,the modified Tokuhashi score system predicted a consistent survival rate of 71.3% in patients with spinal metastases,a 95% confidence interval of 62.96%-79.63%,and an overall median survival time and mean survival time of 5.000 months and 15.066 months.The 0-8,9-11,and 12-15 groups predicted survival rates were 82.3%,47.2%,and 90%,respectively,among them the patient's age(p=0.008),general condition(p=0.009),metastases to the major internal organs(p=0.007),primary site of the cancer(p=0.020)were independent factors considered to influence survival prognosis.Conclusion: The modified Tokuhashi score system is a useful predictor of survival prognosis in patients with spinal metastases.