https://scholars.lib.ntu.edu.tw/handle/123456789/620409
Title: | Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases | Authors: | Hung-Kuan Yen CHIH-WEI CHEN WEI-HSIN LIN Zhong-Yu Wang CHUAN-CHING HUANG HSUAN-YU CHEN SHU-HUA YANG MING-HSIAO HU |
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. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/620409 | ISSN: | 20770383 | DOI: | 10.3390/jcm11185391 |
Appears in Collections: | 醫學院附設醫院 (臺大醫院) |
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.