|Title:||Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases||Authors:||Hung-Kuan Yen
|Keywords:||body mass index;neoplasm staging;spine metastases;surgical oncology;survival;target therapy||Issue Date:||14-Sep-2022||Publisher:||MDPI||Journal Volume:||11||Journal Issue:||18||Source:||Journal of Clinical Medicine||Abstract:||
Introduction: Predicting survival time for patients with spinal metastases is important in treatment choice. Generally speaking, six months is a landmark cutoff point. Revised Tokuhashi score (RTS), the most widely used scoring system, lost its accuracy in predicting 6-month survival, gradually. Therefore, a more precise scoring system is urgently needed. Objective: The aim of this study is to create a new scoring system with a higher accuracy in predicting 6-month survival based on the previously used RTS. Methods: Data of 171 patients were examined to determine factors that affect prognosis (reference group), and the remaining (validation group) were examined to validate the reliability of a new score, adjusted Tokuhashi score (ATS). We compared their discriminatory abilities of the prediction models using area under receiver operating characteristic curve (AUC). Results: Target therapy and the Z score of BMI (Z-BMI), which adjusted to the patients’ sex and age, were additional independent prognostic factors. Patients with target therapy use are awarded 4 points. The Z score of BMI could be added directly to yield ATS. The AUCs were 0.760 for ATS and 0.636 for RTS in the validation group. Conclusion: Appropriate target therapy use can prolong patients’ survival. Z-BMI which might reflect nutritional status is another important influencing factor. With the optimization, surgeons could choose a more individualized treatment for patients.
|Appears in Collections:||醫學院附設醫院 (臺大醫院)|
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