Agreement in the assessment of metastatic spine disease using scoring systems

Arana, Estanislao; Kovacs, Francisco M.; Royuela, Ana; Asenjo, Beatriz; Pérez-Ramírez, Úrsula; Zamora, Javier; Abraira, Víctor; Alcázar, Lucía; Alonso, Ana; Álvarez, Luis Gonzalo; Álvarez, Marco Antonio Santamaría; Amengual, Guillermo; Antuña, Aida; Aparici, Fernando; Bagó, Joan; Barriga, Andrés; Barrios, María Dolores Mondéjar; Bas, Paloma; Begara, J.; Bravo-Rodríguez, Francisco de Asís; Cabrera, A; Casillas, Carlos; Catalán, Gregorio; Conde, Antonio José; Peñas, R. de las; Diaz, Laura K.; Dualde, Diego; Estremera, Ana; Fenollosa, J.; Fernández, Carlos Iglesias; Fernández, Eva; Fernández-Baíllo, Nicomedes; Ferrer, Pilar; Fuster, Salvador; Galarraga, María Isabel; García-Villar, C.; García-Ferrer, Luis; Garcia, Maria Isabel Osorio; García-Duque, Sara; Garde, J.; Gonzalez, Andres A.; González, R. Rivera; Hernández-Fernández, Alberto; Hernando, O.; Hernánz, R.; Hervás, A.; Holgado, Esther; Juan, María José; Lazo, A.; Lersundi, Ana; López, E.; Magallón, Rosa; Majem, Margarita; Antonio, Martín; Martı́n, Marı́a Isabel; Martínez, Juan Agustín Franco; Montoya, Julia; Moreno, Paloma; Navarro, Arturo; Noguerón, Esther; Méndivil, Ana Ortiz de; Palomino, J.C.; Paniagua, Juan Carlos; Pereira, David; Pérez-Romasanta, Luis A.; Perez, R. Sirera; Piñera, Ángel R.; Piñero, Pilar; Plata‐Bello, Julio; Poblete, José; Ramírez, José; Rivas, D. Sarango; Roldán, Héctor; Ruiz, Fernando; Sánchez, José Miguel; Sancho, S.; Sarasíbar, H.; Sepúlveda, Juan Manuel; Silvestre, Antonio; Tomé-Bermejo, Félix; Tovar, I.; Vallejo, María del Carmen; Vanaclocha, Vicente; Villanueva, Asunción; Zamarro, Joaquín; Zazpe, Idoya

doi:10.1016/j.radonc.2015.03.016

Cited by 13 publications

(5 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Patients with spine metastasis are living longer due to the development of targeted therapy, new chemotherapeutic agents, and hormonal therapies. 23,24 The underestimation of life expectancy of scores and subsequent inadequate treatment of spinal metastases for a long-term survival patients may be insufficient to assure a good quality of life over an extended period of time. Therefore, the gain in survival produced by recent anticancer agents should be considered in a new scoring system.…”

Section: Discussionmentioning

confidence: 99%

Who are the Best Candidates for Decompressive Surgery and Spine Stabilization in Patients With Metastatic Spinal Cord Compression?

Lei

Liu

et al. 2016

Spine

View full text Add to dashboard Cite

Study Design.A retrospective study.Objective.This study aims to develop a new scoring system that can guild surgeons to select the best candidates for decompressive surgery in patients with metastatic spinal cord compression (MSCC).Summary of Background Data.Predicting survival and functional outcome is essential when selecting the individual treatment for patients with MSCC. The criteria for identifying MSCC patients who are most likely to benefit from decompressive surgery remain unclear.Methods.We retrospectively analyzed 12 preoperative characteristics for postoperative survival in a series of 206 patients with MSCC who were operated with decompressive surgery and spine stabilization. Characteristics significantly associated with survival in the multivariate analysis were included in the scoring system. Postoperative function outcome was also analyzed on the basis of the scoring system.Results.According to the multivariate analysis, primary site (P < 0.01), preoperative ambulatory status (P < 0.01), visceral metastases (P < 0.01), preoperative chemotherapy (P = 0.02), and bone metastasis at cancer diagnosis (P = 0.03) had a significant impact on postoperative survival and were included in the scoring system. According to the prognostic scores, which ranged from 0 to 10 points, three risk groups were designed: 0 to 2, 3 to 5, and 6 to 10 points. The corresponding 6 months survival rates were 8.2%, 56.5%, and 91.5%, respectively (P < 0.01), and postoperative ambulatory rates were 35.7%, 73.3%, and 95.9%, respectively (P < 0.01).Conclusion.We present a new scoring system for predicting survival and function outcome of MSCC patients after surgical decompression and spine stabilization. This new scoring system can help surgeons select the best candidates for surgical treatment.Level of Evidence: 4

show abstract

Section: Discussionmentioning

confidence: 99%

Who are the Best Candidates for Decompressive Surgery and Spine Stabilization in Patients With Metastatic Spinal Cord Compression?

Lei

Liu

et al. 2016

Spine

View full text Add to dashboard Cite

show abstract

“…[ 4 ] The simpler scores (Tomita and modified Bauer) have more reliable results. [ 1 ] Our study showed that Tomita had the least P value ( P value = 0.00), and the modified Bauer ( P value = 0.002) was a simple and universally applicable prognostic system. SINS had a minimal role in predicting the overall survival and was considered as an add-on support in providing insights to the need of fusion [Figures 6 and 7 ].…”

Section: Discussionmentioning

confidence: 89%

“…The Bauer and Tomita scoring systems have showed statistical significance in predicting survival vs. the other scores. [ 1 ] Notably, the Tokuhashi score is more complicated and includes many other variables, and thus results in decreased predictive reliability. [ 4 ] The simpler scores (Tomita and modified Bauer) have more reliable results.…”

Section: Discussionmentioning

confidence: 99%

Surgically treated spinal metastases: Do prognostic scores have a role?

Afsar¹,

Qadeer²,

Sharif³

2017

Surg Neurol Int

View full text Add to dashboard Cite

Background:The outcome for patients with metastatic disease in spine is difficult to predict. Multiple scoring systems were utilized in this study to determine their effectiveness in predicting long-term prognoses.Methods:A retrospective analysis of surgically treated patients of spinal metastasis was performed between 2005 and 2016. Data were collected prospectively during which 8 patients were lost to follow-up. Ultimately, data from 63 patients were reviewed. Treatment and prognoses were analyzed utilizing various scoring systems including the SINS, the Tomita, the modified Tokouhashi and Bauer scores.Results:Records of 63 patients, averaging 54 years of age, were analyzed. The Tomita score was applied in 44 patients, a modified Bauer score was studied in 49 patients, while SINS and modified Tokouhashi scores were calculated in all 63 patients. The hazard ratios for the Tomita score were 1, 0.030, 0.622, and 0.272, respectively. The hazard ratios for the modified Bauer scores were 1, 4.663, and 1.622, respectively. The Tokouhashi ratios were 1, 1.656, and 0.501, respectively. Of interest, the Tomita scores provided the highest statistical significance (P = 0.000) followed by the Bauer (P = 0.002) and Tokuhashi scores (P = 0.003). Notably, the SINS score showed no significant correlation in predicting patient survival.Conclusion:For evaluating the metastatic spine disease, this study evaluated the prognostic efficacy of four widely used scores: the Tomita, score, the modified Tokouhashi and Bauer scores, and the SINS scores. The Tomita scores provided the highest statistical significance, followed by the Bauer, and Tokuhashi scores, while the SINS score showed no significant correlation in predicting patient survival.

show abstract

“…This is consistent with previous studies on the interpretation of spine imaging. [23][24][25][26] For patients with metastatic spine disease, surgeons' assessment of imaging is often considered the reference for referral to surgery. 27 However, no significant differences existed across surgical and nonsurgical specialties when these clinicians assessed the spinal instability score.…”

Section: Discussionmentioning

confidence: 99%

Metastatic Versus Osteoporotic Vertebral Fractures on MRI: A Blinded, Multicenter, and Multispecialty Observer Agreement Evaluation

Arana

Kovacs

Royuela

et al. 2020

Journal of the National Comprehensive Cancer Network

Self Cite

View full text Add to dashboard Cite

Background: MRI is assumed to be valid for distinguishing metastatic vertebral fractures (MVFs) from osteoporotic vertebral fractures (OVFs). This study assessed (1) concordance between the imagebased diagnosis of MVF versus OVF and the reference (biopsy or follow-up of .6 months), (2) interobserver and intraobserver agreement on key imaging findings and the diagnosis of MVF versus OVF, and (3) whether disclosing a patient's history of cancer leads to variations in diagnosis, concordance, or agreement. Patients and Methods: This retrospective cohort study included clinical data and imaging from 203 patients with confirmed MVF or OVF provided to 25 clinicians (neurosurgeons, radiologists, orthopedic surgeons, and radiation oncologists). From January 2018 through October 2018, the clinicians interpreted images in conditions as close as possible to routine practice. Each specialist assessed data twice, with a minimum 6-week interval, blinded to assessments made by other clinicians and to their own previous assessments. The kappa statistic was used to assess interobserver and intraobserver agreement on key imaging findings, diagnosis (MVF vs OVF), and concordance with the reference. Subgroup analyses were based on clinicians' specialty, years of experience, and complexity of the hospital where they worked. Results: For diagnosis of MVF versus OVF, interobserver agreement was fair, whereas intraobserver agreement was substantial. Only the latter improved to almost perfect when a patient's history of cancer was disclosed. Interobserver agreement for key imaging findings was fair or moderate, whereas intraobserver agreement on key imaging findings was moderate or substantial. Concordance between the diagnosis of MVF versus OVF and the reference was moderate. Results were similar regardless of clinicians' specialty, experience, and hospital category. Conclusions: When MRI is used to distinguish MVF versus OVF, interobserver agreement and concordance with the reference were moderate. These results cast doubt on the reliability of basing such a diagnosis on MRI in routine practice.

show abstract

Agreement in the assessment of metastatic spine disease using scoring systems

Cited by 13 publications

References 29 publications

Who are the Best Candidates for Decompressive Surgery and Spine Stabilization in Patients With Metastatic Spinal Cord Compression?

Who are the Best Candidates for Decompressive Surgery and Spine Stabilization in Patients With Metastatic Spinal Cord Compression?

Surgically treated spinal metastases: Do prognostic scores have a role?

Metastatic Versus Osteoporotic Vertebral Fractures on MRI: A Blinded, Multicenter, and Multispecialty Observer Agreement Evaluation

Contact Info

Product

Resources

About