Abstract
Objective: To assess the validity of the Tokuhashi and Tomita scoring systems in the prediction of prognosis following spinal surgery for skeletal metastases.
Design: A retrospective cohort study of patients treated in a specialist spinal unit
Subjects: All patients undergoing definitive surgery for metastastes of the spine were considered eligible. Time to death or current length of survival was available in 147* of these which was confirmed by the Cancer Registry. Medical and nursing case notes were reviewed and prognostic scores using the methods of Tokuhashi et al, and Tomita et al. were calculated for each patient.
Outcome measures: Mean survival period with 95% confidence intervals for patients grouped according to prognostic score.
Results: Thirty-two patients were still alive and 113 had confirmed death dates. Forty-three patients had Tokuhashi scores of 9 or greater with a mean survival of 20.1 months (95% confidence interval 5.8 months) compared to 9.5 months (2.9 months) for scores 6–8 and 3.5 months (1.8 months) for scores below this. Tomita scoring showed a similar trend with those with better prognostic profiles but without the same degree of statistical significance. The overall 30-day mortality was 8.2% with no significant difference between any other groups.
Conclusion: In patients presenting with metastatic disease involving the spine, published prognostic profiles offer some guidance to likely survival of the patient and so the appropriateness of surgical treatment.
Abstracts prepared by Mr. A. J. Stirling, FRCS, and Miss A. Weaver. Correspondence should be addressed to Miss A. Weaver at the Research and Teaching Centre, Royal Orthopaedic Hospital, Northfield, Birmingham, B31 2AP, UK
BritSpine 2002, the second combined meeting of the British Association of Spinal Surgeons, the British Cervical Spine Society, The British Scoliosis Society and the Society for Back Pain Research, took place at the International Convention Centre in Birmingham UK between 27th February and 1st March 2002. The following presentations and posters were given and displayed.
