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Saturday, March 3, 2001

Revised scoring system makes better forecasts

A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis improved the accuracy of forecasting the period of survival to 78.7 percent from 63.3 percent in 1997.

This revised system was more appropriate to indicate the operative procedure for a metastatic spine tumor than the previous one, said the researchers in poster exhibit 167.

To improve the accuracy, the revised system was examined in 150 patients who had died after surgery. Six parameters (general condition, extraspinal bone metastases foci, metastases in the vertebral body, metastases in the major internal organs, primary site of the cancer, severity of palsy) were assessed. Though each parameter was assigned a score from 0 to 2 points in the original system, the parameter of the primary site of the cancer changed to a 0-5-point system. As a result, the total score obtained for each patient could be correlated with the prognosis (p <0.0001).

It was found that 95.7 percent of patients who scored under 5 points survived for less than 6 months, while 94.1 percent of patients who scored above 12 points survived more than one year. In the group scoring between 6 and 8 points, 61.0 percent of patients survived for less than 6 months. In the group scoring between 9 and 11 points, 71.1 percent of patients survived for more than 6 months.

There were significant differences in the survival of the three groups scoring from 0 to 8, from 9 to 11, and from 12 to 15 points, respectively, and these criteria were valuable in predicting prognosis in each of these groups. The accuracy of these criteria for predicted prognosis in forecasting the period of survival was improved to 78.7 percent.

The researchers are Yasuaki Tokuhashi, MD; Hiromi Matsuzaki, MD; Junosuke Ryu, MD; and Yoshinao Uematsu, MD, all of the department of orthopaedic surgery, Nihon University, Tokyo, Japan

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2001 Academy News March 3 Index C

Last modified 16/February/2001 by IS