Tomita et al developed a scoring system for evaluating a patient with metastases to the vertebral spine. This can help guide the surgical management. The authors are from the Kanazawa University in Japan.
Parameters:
(1) growth rate of the primary tumor (associated with grade of malignancy)
(2) visceral metastases (to lung, liver, kidney, brain, etc)
(3) pattern of bone metastases
|
Parameter |
Findings |
Points |
|
growth rate |
slow growth rate |
1 |
|
|
moderate (intermediate) growth rate |
2 |
|
|
high (rapid) growth rate |
4 |
|
visceral metastases |
none |
0 |
|
|
treatable |
2 |
|
|
untreatable |
3 |
|
pattern of bone metastases |
solitary or isolated |
1 |
|
|
multiple |
2 |
where:
• A rapid growth is usually associated with cancer of the lung, liver, colon and stomach.
• A moderate growth rate is usually associated with cancer of the kidney and endometrium.
• A slow growth rate is usually associated with cancer of the breast, prostate and thyroid.
total score =
= SUM(points for all 3 parameter)
Interpretation:
• minimum score: 2
• maximum score: 10
• The higher the score the more serious the disease.
|
Total Score |
Management |
|
2 or 3 |
long-term control with wide or marginal tumor excision |
|
4 or 5 |
local control with marginal or intra-lesional excision |
|
6 or 7 |
palliative surgery for short-term tumor control |
|
8 to 10 |
supportive care for terminal illness |
Specialty: Hematology Oncology, Surgery, general
ICD-10: ,
