Is Tokuhashi score suitable for evaluation of life expectancy before surgery in Iranian patients with spinal metastases?

Abstract

BACKGROUND: One of the most important selection criteria for spinal metastases surgery is life expectancy and the most important system for this prediction has been proposed by Tokuhashi. The aim of this study was to evaluate predictive value of the Tokuhashi score for life expectancy in Iranian patients with spinal metastases one year after diagnosis. METHODS: From February 2007 to March 2009, of 180 patients suffering spinal metastatic tumors, 71 patients were excluded. This left a study population of 109 patients with known malignant metastases to spine (56 females and 53 males; mean age, 57 ± 12 years). Tokuhashi revised evaluation system for the prognosis of metastatic spinal tumors was used for all patients. The survival period predicted by this system for the prognosis and the actual survival period after 1 year follow up were evaluated. RESULTS: The predicted survival according to Tokuhashi prognostic scoring system was less than 6 months in 38(34.9%) patients, 6-12 months in 39(35.8%) patients and 1 year or more in 32(29.4%) patients. 39 (35.8%) patients died at first six-month of the follow up, 28(25.7%) patients at the second six-month period and 42(38.5%) patients were alive at the end of the year. There was no significant difference between predicted and actual survival time (p = 0.116). CONCLUSIONS: Present study showed that the Tokuhashi revised scoring system may be practicable and highly predictive preoperative scoring system for patients with spinal metastases in Iran.