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Evaluation and modification of the Tomita score in 217 patients with vertebral metastases
Benjamin Ulmar1, Heiko Reichel, Sibel Catalkaya
1Department of Orthopedics, University of Ulm, Germany. benjamin.ulmar@medizin.uni-ulm.de
Background:
The Tomita prognosis score consists of the following 3 parameters: growth behavior, evidence of visceral metastases, and/or evidence of bony metastases.
Methods:
217 consecutive patients, surgically treated for vertebral metastases of different entities, were studied retrospectively. The score according to Tomita was determined.
Results:
In the study group, the Tomita score showed significant results for the estimation of life expectancy of the different prognostic groups (p < 0.0001), but the analysis showed a low reliability, i.e. correlation between predicted prognosis and real survival. A modified division of the patients based on the total sum of points allowed a significant separation (p < 0.0001) of patients into 2 prognostic groups with a real survival of more or less than 12 months.
Conclusion:
In our study, the original Tomita score was not reliable to predict the life expectancy of cancer patients with spinal metastases. Our modification allows a significant differentiation of patients with spinal metastases with a prognosis of more or less than 12 months.