Skip to main content

Advertisement

SpringerLink
Log in

Prognosis Scores of Tokuhashi and Tomita for Patients With Spinal Metastases of Renal Cancer

  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Retrospective evaluation of the prognosis scores of Tokuhashi and Tomita for life expectancy in 37 consecutive patients with spinal metastases secondary to renal cancer who underwent surgery. The score of Tokuhashi, composed of six parameters, each rated from zero to two, has been proposed in 1990 for the prognostic assessment of patients with spinal metastases. In 2001, Tomita et al. created another prognostic score, composed of three parameters, growth behaviour of the primary tumor (slow, moderate and rapid) and the evidence of visceral and bony metastases.

Methods

Thirty-seven patients, surgically treated for vertebral metastases secondary to renal cancer were studied. The scores according to Tokuhashi and Tomita were calculated for each patient.

Results

Applying the Tokuhashi Score for the estimation of life expectancy of renal cancer patients with vertebral metastases was found to provide very reliable results with a statistically high significance. The analysis according to Tomita showed no correlation between predicted and real survival. The statistical analysis did not show any significance.

Conclusion

For surgical decisions in renal cancer patients with spinal metastases, the prognostic score of Tokuhashi appears to be much more valuable than the Tomita score.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

FIG. 1.
FIG. 2.
FIG. 3.

Similar content being viewed by others

References

  1. Harrington KD. Orthopedic surgical management of skeletal complications of malignancy. Cancer 1997;80:1614–27

    Article  PubMed  CAS  Google Scholar 

  2. Boland PJ, Lane JM, Sundaresan N. Metastatic disease of the spine. Clin Orthop 1982;169:95–102

    PubMed  Google Scholar 

  3. Enneking WF. Musculoskeletal Tumor Surgery. Vol 2. New York: Churchill Livingston, 1983:1541–59

    Google Scholar 

  4. Harrington KD. The use of methylmethacrylate for vertebral body replacement and anterior stabilization of pathologic fracture dislocation of the spine due to metastatic malignant disease. J Bone Joint Surg Am 1981;63:36–47

    PubMed  CAS  Google Scholar 

  5. Schaberg J, Gainor BJ. A profile of metastatic carcinoma of the spine. Spine 1985;10:19–20

    Article  PubMed  CAS  Google Scholar 

  6. Smith EM, Kursh ED, Makley J, Resnick MI. Treatment of osseous metastases secondary to renal cell carcinoma. J Urol 1992;148:784–7

    PubMed  CAS  Google Scholar 

  7. Jacobsen KD, Folleras G, Fossa SD. Metastases from renal cell carcinoma to the humerus or shoulder girdle. Br J Urol 1994;73:124–8

    Article  PubMed  CAS  Google Scholar 

  8. Tokuhashi Y, Matsuzaki H, Toriyama S, Kawano H, Ohsaka S. Scoring system for the preoperative evaluation of metastatic spine tumor prognosis. Spine 1990;15:1110–3

    Article  PubMed  CAS  Google Scholar 

  9. Tokuhashi Y. Letter to the editor. Spine 2000;25:654

    Article  PubMed  Google Scholar 

  10. Tomita K, Kawahara N, Kobayashi T, Yosihida A, Murakami H, Akamaru T. Surgical strategy for spinal metastases. Spine 2001;3:298–305

    Article  Google Scholar 

  11. Boriani S, Biagini R, De Lure F, et al. En bloc resections of bone tumors of the thoracolumbar spine. A preliminary report on 29 patients. Spine 1996;21:1927–31

    Article  PubMed  CAS  Google Scholar 

  12. Sundaresan N, Steinberger AA, Moore F, et al. Indications and results of combined anterior-posterior approaches for spine tumor surgery. J Neurosurg 1996;85:438–46

    Article  PubMed  CAS  Google Scholar 

  13. Tomita K, Kawahara N, Baba H, Tsuchiya H, Nagata S, Toribatake Y. Total en bloc spondylectomy for solitary spinal metastases. Int Orthop 1994;18:291–8.

    Article  PubMed  CAS  Google Scholar 

  14. Dick W. Fixateur interne. State of the art reviews. Spine 1992;6:147–72

    Google Scholar 

  15. Gertzbein SD. Neurologic deterioration in patients with thoracic and lumbar fractures after admission to the hospital. Spine 1994;19:1723–9

    Article  PubMed  CAS  Google Scholar 

  16. Gertzbein SD, Court-Brown CM, Marks P, et al. The neurological outcome following surgery for spinal fractures. Spine 1988;13:641–4

    Article  PubMed  CAS  Google Scholar 

  17. Hertlein H, Hartl WH, Dienemann H, Schurmann M, Lob G. Thoracoscopic repair of thoracic spine trauma. Eur Spine J 1995;1:142–51

    Google Scholar 

  18. Lord CF, Herndon JH. Spinal cord compression secondary to kyphosis associated with radiation therapy for metastatic disease. Clin Orthop Rel Res 1986;210:120–7

    Google Scholar 

  19. Enkaoua EA, Doursounian L, Chatellier G, Mabesoone F, Aimard T, Saillant G. Vertebral metastases. A critical appreciation of the prognostic Tokuhashi Score in a series of 71 cases. Spine 1997;22:2293–8

    Article  PubMed  CAS  Google Scholar 

  20. Riegel T, Schilling T, Sitter H, et al. Analysis of factors affecting the prognosis of vertebral metastases. Zentralbl Neurochir 2002;63:2–6

    Article  PubMed  CAS  Google Scholar 

  21. Ulmar B, Richter M, Cakir B, Muche R, Puhl W, Huch K. The Tokuhashi Score: significant predictive value for the life expectancy of breast cancer patients with spinal metastases. Spine 2005;30:2222–5

    Article  PubMed  Google Scholar 

  22. Chataigner H, Onimus M. Surgery in spinal metastasis without spinal cord compression: indications and strategy related to the risk of recurrence. Eur Spine J 2000;9:523–7.

    Article  PubMed  CAS  Google Scholar 

  23. Karnofsky DA. Clinical evaluation of anticancer drugs: cancer chemotherapy. GANN Monogr 1967;22:223–31

    Google Scholar 

  24. Nazarian S, Guigui P, Gouvernet J. Place de la chirurgie dans le traitement des métastses du rachis. Résultats globaux. Rev Chir Orthop 1997;83(Suppl 3):141–4

    Google Scholar 

  25. Dürr HR, Maier M, Pfahler M, Baur A, Refior HJ. Surgical treatment of osseous metastases in patients with renal cell carcinoma. Clin Orthop 1999;367:283–90

    PubMed  Google Scholar 

  26. Dürr HR, Müller PE, Lenz T, Baur A, Jansson V, Refior HJ. Surgical treatment of bone metastases in patients with breast cancer. Clin Orthop 2002;396:191–6

    Article  PubMed  Google Scholar 

  27. Swenerton KD, Legha SS, Smith T, et al. Prognostic factors in metastatic breast cancer treated with combination chemotherapy. Cancer Res 1979;39:1552–62

    PubMed  CAS  Google Scholar 

  28. Yamashita K, Yonenobu S, Fuji T. Staging of metastatic spinal tumor. Ringsho Seikei Geka 1986;21:445–50

    Google Scholar 

  29. Brice J, McKissock W. Surgical treatment of malignant extradural spinal tumors. BMJ 1965;1:1341–4

    Article  PubMed  CAS  Google Scholar 

  30. Constans JP, de Divitiis E, Donzelli R, Spaziante R, Meder JF, Haye C. Spinal metastases with neurological manifestations. J Neurosurg 1983;59:111–8

    PubMed  CAS  Google Scholar 

  31. Hall AJ, McKay NS. The result of laminectomy in compression of the cord or cauda equina by extradural malignant tumor. J Bone Joint Surg Br 1973;55:497–505

    PubMed  CAS  Google Scholar 

  32. Onimus M, Schraub S, Bertin D, Bosset JF, Guidet M. Surgical treatment of vertebral metastases. Spine 1986;11:883–91

    Article  PubMed  CAS  Google Scholar 

  33. Tatsui H, Onomura T, Morishita S, Oketa M, Inoue T. Survival rates of patients with metastatic spinal cancer after scintigraphic detection of abnormal radioactive accumulation. Spine 1996;18:2143–8

    Article  Google Scholar 

  34. White WA, Patterson RH, Bergland RM. Role of surgery in the treatment of spinal cord compression by metastatic neoplasm. Cancer 1971;27:558–61

    Article  PubMed  CAS  Google Scholar 

  35. Young RF, Feldmann RA. Metastatic tumor of the spine. J Neurosurg 1979;50:536–7

    PubMed  CAS  Google Scholar 

  36. Harrington KD. Metastatic disease of the spine. J Bone Joint Surg Am 1986;68:1110–5

    PubMed  CAS  Google Scholar 

  37. Spiegel DA, Sampson JH, Richardson WJ, et al. Metastatic melanoma to the spine. Diagnosis, risk factors and prognosis in 114 patients. Spine 1995;20:2141–6

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Orthopedics, University of Ulm, Oberer Eselsberg 45, D-89081, Ulm, Germany

    Benjamin Ulmar MD, Ulrike Naumann BSc, Sibel Catalkaya BSc, Balkan Cakir MD, Rene Schmidt MD, Heiko Reichel MD, Professor & Klaus Huch MD

  2. Department of Biometry and Medical Documentation, University of Ulm, Schwabstrasse 13, D-89075, Ulm, Germany

    Rainer Muche PhD

Authors
  1. Benjamin Ulmar MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ulrike Naumann BSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Sibel Catalkaya BSc
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Rainer Muche PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Balkan Cakir MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Rene Schmidt MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Heiko Reichel MD, Professor
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Klaus Huch MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Benjamin Ulmar MD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ulmar, B., Naumann, U., Catalkaya, S. et al. Prognosis Scores of Tokuhashi and Tomita for Patients With Spinal Metastases of Renal Cancer. Ann Surg Oncol 14, 998–1004 (2007). https://doi.org/10.1245/s10434-006-9000-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-006-9000-5

Keywords

Search

Navigation