The decision-making and survival prediction role of Tomita score in the management spinal metastases

English Keywords:Spinal metastases  Tomita score  Surgery  Survival time

English Abstract:

  【Abstract】 Objectiveｓ: To investigate the decision-making and survival prediction role of Tomita score in the management of spinal metastases. Methods: A retrospective analysis of 108 patients of spinal metastases from January 2002 to December 2008 in our hospital was performed. There were　66 males and 42 females with ａｎ average age of 57.9 years(range, 17 to 86 years). 44 cases underwent surgery, while conservative treatment was indicated for 64 cases. All cases were divided into four groups according to different Tomita scores: group A(2-3 points); group B(4-5 points); group C(6-7 points); group D(8-10 point). The survival time(complete data of 105 cases and censored data of 3 cases) in four groups were analyzed statistically. Results: The follow-up was 2-46 months, with an average of 14.7 months. At final follow-up of July 2011, 1 survival and 2 loss of follow-up were noted. 108 cases had a total average survival time of 10.3 months with the median survival time of 8 months, 1-year survival rate was 31.48%, among which 4 cases in group A had an average survival time of 24.75 months and the median survival time of 15 months, with the 1-year survival rate of 75%; in group B, 18 patients had a mean survival time of 15.58 months, the median survival time of 15 months, and 1-year survival rate of 66.66%; in group C, 31 patients had a mean survival time of 11.74 months, the median survival time of 11 months, and 1- year survival rate of 48.39%; in group D, 55 patients had a mean survival time of 6.65 months, the median survival time of 6 months, 1-year survival rate of 7.27%. Non-parametric estimate of the survival time of 4 groups by using log-rank test analysis showed significant differences(P<0.0001). The survival time and Tomita prognosis score were negatively correlated by using spearman rank correlation analysis, the lower score of Tomita score, the longer survival time and good prognosis, with relative coefficients of -0.5868(P<0.0001). Conclusions： Tomita score is associated with the prognosis of spinal metastases, which acts as a referent to determine the treatment protocols.