Consistency and accuracy of four prognostic scoring systems in predicting prognosis of patients with spinal metastasis

XIE Fang; JIANG Xinting; ZHANG Rui; HUA Yang; LIANG Li

doi:10.7619/jcmp.20232326

Journal of Clinical Medicine in Practice > 2023 > 27(21): 52-58. > DOI: 10.7619/jcmp.20232326

XIE Fang, JIANG Xinting, ZHANG Rui, HUA Yang, LIANG Li. Consistency and accuracy of four prognostic scoring systems in predicting prognosis of patients with spinal metastasis[J]. Journal of Clinical Medicine in Practice, 2023, 27(21): 52-58. DOI: 10.7619/jcmp.20232326

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Consistency and accuracy of four prognostic scoring systems in predicting prognosis of patients with spinal metastasis

1.
Department of Nursing, Yibin Third People′s Hospital in Sichuan Province, Yibin, Sichuan, 644000
2.
Department of Orthopedics, Yibin First People′s Hospital in Sichuan Province, Yibin, Sichuan, 644000
3.
Department of Oncology, Yibin Third People′s Hospital in Sichuan Province, Yibin, Sichuan, 644000
4.
Department of Gastroenterology, Yibin Third People′s Hospital in Sichuan Province, Yibin, Sichuan, 644000

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Received Date: July 23, 2023
Revised Date: October 08, 2023
Available Online: November 23, 2023

Graphical Abstract

Abstract

Abstract

Objective
To explore the consistency and accuracy of Tomita score, revised Tokuhashi score, Rades score and Oswestry spinal risk index (OSRI) in predicting the prognosis of patients with spinal metastasis.
Methods
The medical records of 127 hospitalized patients with spinal metastasis admitted to two comprehensive hospitals in Yibin City from January 2010 to December 2020 were collected, and the deadline for follow-up was June 30, 2022. The Kaplan-Meier method was used to draw the survival curve, the Log-rank Chi-square test and Cox regression analysis were used to analyze the factors affecting prognosis, the Kappa value was used to evaluate the consistency between predicted and actual survival time, and area under the curve (AUC) was used to evaluate the accuracy of four scoring systems in predicting survival time of patients with spinal metastases.
Results
The patient′s survival time was 10 (6, 14) months, with a mortality rate of 76.38% during the follow-up period, and the 6-month and 12-month survival rates were 69.3% and 27.6% respectively. The AUC values of Tomita score, revised Tokuhashi score, Rades score and OSRI in predicting patient′s survival time were 0.968, 0.957, 0.930 and 0.798 respectively, with the optimal cut-off values of 4.5, 10.5, 36.5 and 2.5. Cox regression analysis showed that the four factors such as Tomita score, revised Tokuhashi score, Rades score and presence or absence of visceral metastasis were the predictive factors for the prognosis of patients with spinal metastasis; the hazard ratio (HR) values for revised Tokuhashi score ≤ 8 and 9 to 11 were 9.328 and 6.417 respectively, the HR values for Tomita score 2 to 3, 4 to 5 and 6 to 7 were 0.183, 0.197 and 0.398 respectively, the HR values for Rades score ≤ 30 and 31 to 35 were 2.898 and 2.166 respectively, and the HR for resectable and non-resectable visceral metastases were 1.517 and 4.116, respectively. The revised Tokuhashi score predicted a Kappa value >0.40 for 6-month and 12-month survival rates, while the Tomita score, Rades score and OSRI predicted a Kappa value < 0.40. The revised Tokuhashi score had the highest accuracy in predicting patient′s 6-month survival (AUC=0.863), the Tomita score had average accuracy (AUC=0.717), and the Rades score and OSRI had poor accuracy (AUC < 0.70).
Conclusion
The prognosis of patients with spinal metastasis is poor, and the prognosis is related to multiple factors. The revised Tokuhashi score has relatively high accuracy and consistency in predicting prognosis of patients.
- spinal metastasis,
- Tomita score,
- revised Tokuhashi score,
- Rades score,
- Oswestry spine risk index,
- prognosis

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References (26)

References

[1]	GE L, ARUL K, MESFIN A. Spinal cord injury from spinal tumors: prevalence, management, and outcomes[J]. World Neurosurg, 2019, 122: e1551-e1556. doi: 10.1016/j.wneu.2018.11.099
[2]	PARK S J, MA C H, LEE C S, et al. Survival and functional outcomes after surgical treatment for spinal metastasis in patients with a short life expectancy[J]. J Clin Med, 2022, 12(1): 46. doi: 10.3390/jcm12010046
[3]	MCCABE F J, JADAAN M M, BYRNE F, et al. Spinal metastasis: the rise of minimally invasive surgery[J]. Surgeon, 2022, 20(5): 328-333. doi: 10.1016/j.surge.2021.08.007
[4]	BARZILAI O, FISHER C G, BILSKY M H. State of the art treatment of spinal metastatic disease[J]. Neurosurgery, 2018, 82(6): 757-769. doi: 10.1093/neuros/nyx567
[5]	ORENDAY-BARRAZA J M, CAVAGNARO M J, AVILA M J, et al. 10-year trends in the surgical management of patients with spinal metastases: AScoping review[J]. World Neurosurg, 2022, 157: 170-186, e3. doi: 10.1016/j.wneu.2021.10.086
[6]	KRAMER A, COβMANN T, JÄGERSBERG M, et al. The Oswestry Spinal Risk Index (OSRI) in assessing prognosis of patients with spinal metastases[J]. Brain Spine, 2022, 2: 100875. doi: 10.1016/j.bas.2022.100875
[7]	FAYE M, BARRY L F, KAYA J M, et al. Spinal metastases of bronchopulmonary cancer: role of spinal surgery and value of prognostic scores (Modified Tokuhashi and Tomita)[J]. Neurochirurgie, 2022, 68(6): 569-574. doi: 10.1016/j.neuchi.2022.06.007
[8]	GHORI A K, LEONARD D A, SCHOENFELD A J, et al. Modeling 1-year survival after surgery on the metastatic spine[J]. Spine J, 2015, 15(11): 2345-2350. doi: 10.1016/j.spinee.2015.06.061
[9]	SCHOENFELD A J, LOSINA E, FERRONE M L, et al. Ambulatory status after surgical and nonsurgical treatment for spinal metastasis[J]. Cancer, 2019, 125(15): 2631-2637. doi: 10.1002/cncr.32140
[10]	TOMITA K, KAWAHARA N, KOBAYASHI T, et al. Surgical strategy for spinal metastases[J]. Spine, 2001, 26(3): 298-306. doi: 10.1097/00007632-200102010-00016
[11]	YAN Y, ZHONG G Q, LAI H H, et al. Comparing the accuracy of seven scoring systems in predicting survival of lung cancer patients with spinal metastases: an external validation from two centers[J]. Spine, 2023, 48(14): 1009-1016. doi: 10.1097/BRS.0000000000004576
[12]	张睿, 张意虎, 张玉容, 等. 修订Tokuhashi评分在预测脊柱转移瘤患者临床预后及治疗方式选择中的价值[J]. 现代肿瘤医学, 2023, 31(15): 2910-2915. doi: 10.3969/j.issn.1672-4992.2023.15.027
[13]	TABOUREL G, TERRIER L M, DUBORY A, et al. Are spine metastasis survival scoring systems outdated and do they underestimate life expectancy?Caution in surgical recommendation guidance[J]. J Neurosurg Spine, 2021, 35(4): 527-534. doi: 10.3171/2020.12.SPINE201741
[14]	王维青. Rades评分对转移性脊髓压迫症放疗相关生存预后的评估价值分析[J]. 中国医师进修杂志, 2020, 43(9): 804-807.
[15]	FLEMING C, BAKER J F, O'NEILL S C, et al. The Oswestry Spinal Risk Index (OSRI): an external validation study[J]. Eur Spine J, 2016, 25(1): 252-256. doi: 10.1007/s00586-014-3730-z
[16]	WEISS F, LAUFFENBURGER D, FRIEDL P. Towards targeting of shared mechanisms of cancer metastasis and therapy resistance[J]. Nat Rev Cancer, 2022, 22(3): 157-173. doi: 10.1038/s41568-021-00427-0
[17]	TSUKAMOTO S, KIDO A, TANAKA Y, et al. Current overview of treatment for metastatic bone disease[J]. Curr Oncol, 2021, 28(5): 3347-3372. doi: 10.3390/curroncol28050290
[18]	LEI M X, LI J J, LIU Y S, et al. Who are the best candidates for decompressive surgery and spine stabilization in patients with metastatic spinal cord compression?: a new scoring system[J]. Spine, 2016, 41(18): 1469-1476. doi: 10.1097/BRS.0000000000001538
[19]	MEZEI T, HORVÁTH A, POLLNER P, et al. Research on the predicting power of the revised Tokuhashi system: how much time can surgery give to patients with short life expectancy[J]. Int J Clin Oncol, 2020, 25(4): 755-764. doi: 10.1007/s10147-019-01612-w
[20]	FURLAN J C, WILSON J R, MASSICOTTE E M, et al. Recent advances and new discoveries in the pipeline of the treatment of primary spinal tumors and spinal metastases: a scoping review of registered clinical studies from 2000 to 2020[J]. Neuro Oncol, 2022, 24(1): 1-13. doi: 10.1093/neuonc/noab214
[21]	崔嘉明. 比较八种评分系统对脊柱转移瘤预后评估价值的研究[D]. 广州: 暨南大学, 2020.
[22]	李玉希, 卢世新, 梁育玮, 等. 肺癌脊柱转移瘤的外科治疗疗效及预后因素分析[J]. 中山大学学报: 医学科学版, 2021, 42(6): 923-930. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSYK202106015.htm
[23]	刘鹏, 王专, 章仕元. 手术治疗脊柱转移瘤患者预后影响因素的Logistic及Cox回归模型分析[J]. 现代肿瘤医学, 2018, 26(4): 571-576. https://www.cnki.com.cn/Article/CJFDTOTAL-SXZL201804023.htm
[24]	WIBMER C, LEITHNER A, HOFMANN G, et al. Survival analysis of 254 patients after manifestation of spinal metastases: evaluation of seven preoperative scoring systems[J]. Spine, 2011, 36(23): 1977-1986. doi: 10.1097/BRS.0b013e3182011f84
[25]	HESSLER C, VETTORAZZI E, MADERT J, et al. Actual and predicted survival time of patients with spinal metastases of lung cancer: evaluation of the robustness of the Tokuhashi score[J]. Spine, 2011, 36(12): 983-989. doi: 10.1097/BRS.0b013e3181e8f7f8
[26]	WHITEHOUSE S, STEPHENSON J, SINCLAIR V, et al. A validation of the oswestry spinal risk index[J]. Eur Spine J, 2016, 25(1): 247-251. doi: 10.1007/s00586-014-3665-4

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