Surgery for spinal metastatic tumors: Prognostication systems in clinical practice (Review)

The management of spinal metastatic tumors is a matter of increasing clinical importance, as 20-40% of cancer patients have evidence of vertebral metastatic disease at the time of their passing and up to 20% develop neurological symptoms due to epidural spinal cord compression. The treatment of patients with spinal metastases is challenging, albeit palliative, and it requires a multidisciplinary approach. Accurate prediction of life expectancy of patients with cancer is of paramount importance for therapeutic strategy. Prognostication scoring systems were developed to aid clinicians to follow a more objective, safe and evidence-based approach with therapy selection and surgical intervention indications. In this context, the aim of the present review was to briefly discuss the evolution of scoring systems since their introduction in the early 90s until today, their advantages and shortcomings, and the future requirements for personalized scoring in the era of modern oncology.