The Tokuhashi score: effectiveness and pitfalls

Abstract

The mTS is suggestive of actual survival for patients with a good prognosis. It is less accurate for patients with an estimated survival of less than 12 months. The decreasing trend in mTS accuracy over time will likely further reduce mTS utility. An important opportunity exists to develop new instruments to assist spine surgeons and oncologists to choose appropriate surgical or non-surgical treatment modalities for patients with metastatic spine disease.

The SORG nomogram accurately predicts 3‐ and 12‐months survival for operable spine metastatic disease: External validation

“…Numerous survival algorithms have been proposed for patients with spine metastatic disease; however, it is unclear which is most useful and valid. 7,[12][13][14] In a previous study, the SORG created a nomogram to Based on normal ranges of laboratory values in the hospital of the development set, high white blood cell counts were defined as >11 K/uL, and low hemoglobin levels as <13.5 g/dL. Based on normal ranges of laboratory values in the hospital of the validation set, high white blood cell counts were defined as >11 K/uL, low hemoglobin levels as <11.5 g/dL, and low albumin levels as <4.0 g/dL.…”

“…Many algorithms prognosticate survival for these patients, although one cannot predict individual survival times from these algorithms, and some are merely utilized for surgical planning . Furthermore, many of these algorithms were inaccurate, or were not tested in external patient samples.…”

Survival, local control, and health‐related quality of life in patients with oligometastatic and polymetastatic spinal tumors: A multicenter, international study

“…Historical scoring systems such as the Tokuhashi et al 5 27,28 New prediction models 29 have attempted to overcome the shortcomings of these older models, yet to the best of our knowledge their usefulness also remains unknown. The proposed treatments (ie, surgery or RT) are predicated on whether or not the patient can tolerate the proposed treatment and, furthermore, will they outlive the benefit of these interventions.…”

The Role of Prognostic Scoring Systems in Assessing Surgical Candidacy for Patients With Vertebral Metastasis: A Narrative Review

“…A review by Zoccali et al, which examined 10 studies from the period 2007 to 2013, concluded that the TS was more useful for patients with a good prognosis but less helpful in patients expected to survive less than 1 year. 25 Additionally, other authors have examined the TS with respect to specific tumor subtypes (eg, lung/myeloma) and found the TS to be inaccurate. 26,27 Within this context, caution is advised to any clinician who may either disregard or readily adopt the current TS based on the literature to date.…”