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Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases

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. The...

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Autores principales: Yen, Hung-Kuan, Chen, Chih-Wei, Lin, Wei-Hsin, Wang, Zhong-Yu, Huang, Chuan-Ching, Chen, Hsuan-Yu, Yang, Shu-Hua, Hu, Ming-Hsiao
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503025/
https://www.ncbi.nlm.nih.gov/pubmed/36143035
http://dx.doi.org/10.3390/jcm11185391
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author Yen, Hung-Kuan
Chen, Chih-Wei
Lin, Wei-Hsin
Wang, Zhong-Yu
Huang, Chuan-Ching
Chen, Hsuan-Yu
Yang, Shu-Hua
Hu, Ming-Hsiao
author_facet Yen, Hung-Kuan
Chen, Chih-Wei
Lin, Wei-Hsin
Wang, Zhong-Yu
Huang, Chuan-Ching
Chen, Hsuan-Yu
Yang, Shu-Hua
Hu, Ming-Hsiao
author_sort Yen, Hung-Kuan
collection PubMed
description 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.
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spelling pubmed-95030252022-09-24 Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases Yen, Hung-Kuan Chen, Chih-Wei Lin, Wei-Hsin Wang, Zhong-Yu Huang, Chuan-Ching Chen, Hsuan-Yu Yang, Shu-Hua Hu, Ming-Hsiao J Clin Med Article 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. MDPI 2022-09-14 /pmc/articles/PMC9503025/ /pubmed/36143035 http://dx.doi.org/10.3390/jcm11185391 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Yen, Hung-Kuan
Chen, Chih-Wei
Lin, Wei-Hsin
Wang, Zhong-Yu
Huang, Chuan-Ching
Chen, Hsuan-Yu
Yang, Shu-Hua
Hu, Ming-Hsiao
Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases
title Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases
title_full Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases
title_fullStr Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases
title_full_unstemmed Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases
title_short Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases
title_sort optimization of tokuhashi scoring system to improve survival prediction in patients with spinal metastases
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9503025/
https://www.ncbi.nlm.nih.gov/pubmed/36143035
http://dx.doi.org/10.3390/jcm11185391
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