Universität zu Köln

Westermann, Leonard, Olivier, Alain Christoph, Samel, Christina, Eysel, Peer, Herren, Christian, Sircar, Krishnan and Zarghooni, Kourosh (2020). Analysis of seven prognostic scores in patients with surgically treated epidural metastatic spine disease. Acta Neurochir., 162 (1). S. 109 - 120. WIEN: SPRINGER WIEN. ISSN 0942-0940

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Abstract

BackgroundPrognostic scores have been proposed to guide the treatment of patients with metastatic spine disease (MSD), but their accuracy and usefulness are controversial. The aim of this study was to evaluate seven such prognostic scoring systems. The following prognostic scores were compared: Tomita, Van der Linden (VDL), Bauer modified (BM), Oswestry Spinal Risk Index (OSRI), Tokuhashi original (T90), Tokuhashi revised (TR05), and modified Tokuhashi revised (TR17).MethodsWe retrospectively reviewed all our patients who underwent surgery for spinal metastases, February 2008-January 2015. We classified all 223 patients into the predicted survival-time categories of each of the 7 scoring systems and then tallied how often this was correct vis-a-vis the actual survival time. Accuracy was also assessed using receiver operating characteristic (ROC) analysis at 1, 3, and 12 months.ResultsThe median (95% CI) survival of the 223 patients was 13.6 (7.9-19.3) months. A groupwise ROC analysis showed sufficient accuracy for 3-month survival only for TR17 (area under the curve [AUC] 0.71) and for 1-year survival for T90 (AUC 0.73), TR05 (AUC 0.76), TR17 (AUC 0.76), Tomita (AUC 0.77), and OSRI (AUC 0.71). A pointwise ROC score analysis showed poor prognostic ability for short-term survival (1 and 3 months) with sufficient accuracy for T90 (AUC 0.71), TR05 (AUC 0.71), TR17 (AUC 0.71), and the Tomita score (AUC 0.77) for 1-year survival.ConclusionThe TR17 was the only prognostic system with acceptable performance here. More sophisticated assessment tools are required to keep up with present and future changes in tumor diagnostics and treatment.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Westermann, Leonard UNSPECIFIED UNSPECIFIED UNSPECIFIED Olivier, Alain Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Samel, Christina UNSPECIFIED UNSPECIFIED UNSPECIFIED Eysel, Peer UNSPECIFIED UNSPECIFIED UNSPECIFIED Herren, Christian UNSPECIFIED UNSPECIFIED UNSPECIFIED Sircar, Krishnan UNSPECIFIED UNSPECIFIED UNSPECIFIED Zarghooni, Kourosh UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-351336
DOI:	10.1007/s00701-019-04115-9
Journal or Publication Title:	Acta Neurochir.
Volume:	162
Number:	1
Page Range:	S. 109 - 120
Date:	2020
Publisher:	SPRINGER WIEN
Place of Publication:	WIEN
ISSN:	0942-0940
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PREOPERATIVE EVALUATION; SCORING SYSTEMS; SURVIVAL; CANCER; COLUMN; RISK Multiple languages Clinical Neurology; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/35133