Significant predictive values for the life expectancy in patients with spinal metastasis following surgical treatment

Background Spinal metastasis is a common manifestation of bony metastasis, but for surgeons involved in the treatment of individual patients, it is not easy to choose optimal treatments. Various scoring systems have been designed to predict survival periods and to select optimal treatments, but prognosis is still unpredictable. Objectives are to evaluate the efficiency of the predictive value of preoperative Tokuhashi scores for life expectancy in patients with spinal metastasis and to estimate other prognostic factors affected survival of patients with spinal metastasis. Methods A total of 52 patients that had been surgically treated for vertebral metastasis were enrolled in this study. Twenty were men and 32 were women, and average overall age at operation was 60.6 years (range, 41 to 95 years). Preoperative Tokuhashi scores were calculated and Tomita classifications were determined for all patients. The prognostic value of Tokuhashi scores and the total number of what sort of points were calculated for all patients. Furthermore, the variables used to calculate Tokuhashi scores were categorized for statistical analysis. Fifteen parameters were analyzed with regard to risk factors using the log-rank test for univariate analysis and the Cox proportional hazards model for multivariate analysis. Survival curves were generated by Kaplan-Meier life-table analysis. Results By univariate survival analysis, primary cancer site and preoperative albumin level were found to be significantly associated with survival, and multivariate analysis, which included all fifteen parameters assessed, confirmed that primary cancer site and preoperative albumin were the only significant parameters. When the single variables of Takuhashi scores were analyzed, "primary cancer site" and "preoperative albumin level," a surrogate of nutritional status were found to significantly predict survival. Conclusions In the present study, the mean survival time of patients with spinal metastasis was 10.4 months (median 3.7 months). The most important parameters associated with survival were found to be primary cancer site and nutritional status. This study demonstrates that other parameters are considered for survival prediction in patients with spinal metastasis by the application of Tokuhashi scoring system.