Tokuhashi et al originally developed a score for evaluating a patient with metastastic tumor to the spine. They revised the score later to improve patient evaluation prior to starting therapy . The authors are from Nihon University in Tokyo, Japan.
Patient selection: metastatic carcinoma to the spine
Parameters:
(1) Karnofsky performance scale (KPS)
(2) number of extraspinal bone metastases
(3) number of metastases to vertebral bodies
(4) metastases to major internal organs
(5) primary site of the tumor
(6) spinal cord palsy (based on the Frankel classification(
The revised score changed the scoring for the primary site of the tumor, going from 3 categories to 6.
|
Parameter |
Finding |
Points |
|
Karnofsky Performance Scale |
good (80 to 100) |
2 |
|
|
moderate (50 to 70) |
1 |
|
|
poor (10 to 40) |
0 |
|
number of extraspinal bone metastases |
0 |
2 |
|
|
1 or 2 |
1 |
|
|
>= 3 |
0 |
|
number of metastases to vertebral bodies |
1 |
2 |
|
|
2 |
1 |
|
|
>= 3 |
0 |
|
metastases to major organs |
none |
2 |
|
|
resectable (removable) |
1 |
|
|
unresectable (unremovable) |
0 |
|
primary site for the tumor |
lung, osteosarcoma, stomach, bladder, esophagus, pancreas |
0 |
|
|
liver, gallbladder, unidentified |
1 |
|
|
others |
2 |
|
|
kidney, uterus |
3 |
|
|
rectum |
4 |
|
|
thyroid, breast, prostate, carcinoid tumor |
5 |
|
spinal cord palsy |
none |
2 |
|
|
incomplete (Frankel C or D) |
1 |
|
|
complete (Frankel A or B) |
0 |
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 15
• The higher the score the better the performance.
|
Score |
Predicted Survival |
|
0 to 8 |
< 6 months |
|
9 to 11 |
>= 6 months |
|
12 to 15 |
>= 12 months |
Specialty: Hematology Oncology, Surgery, general
