Tokuhashi score [Neurosurgery Wiki]

This page is read only. You can view the source, but not change it. Ask your administrator if you think this is wrong.
====== Tokuhashi score ======


Metastatic spine tumor prognosis.

The modified Tokuhashi score assists in decision making based on reliable estimators of life expectancy in patients with spinal metastases secondary to breast cancer
((Ulmar B, Richter M, Cakir B, Muche R, Puhl W, Huch K. The Tokuhashi score:
significant predictive value for the life expectancy of patients with breast
cancer with spinal metastases. Spine (Phila Pa 1976). 2005 Oct 1;30(19):2222-6.
PubMed PMID: 16205351.
)).

General condition (Karnofsky)

0 points: poor (10% - 40%)
1 point: moderate (50% - 70%)
2 points: good (80% - 100%)
No. of extraspinal bone metastases foci

0 points: >= 3
1 point: 1 - 2
2 points: 1
No. of metastases in the vertebral body

0 points: >= 3
1 point: 1 - 2
2 points: 1
Metastases to the major internal organs

0 points: unremovable
1 point: removable
2 points: no metastases
Primary site of the cancer

0 points: lung, osteosarcoma, stomach, bladder, esophagus, pancreas
1 point: liver, galbladder, unidentified
2 points: others
3 points: kidney, uterus
4 points: rectum
5 points: thryoid, breast, prostate, carcinoid tumor
Palsy

0 points: complete (Frankel A, B)
1 point: incomplete (Frankel C, D)
2 points: none (Frankel E)
Survival prognosis

total score 0 - 8: 85% lives < 6 months => conservative treatment or palliative surgery
total score 9 - 11: 73% lives > 6 months (and 30% > 1 year) => palliative surgery or (exceptionally) excisional surgery
total score 12 - 15: 95% lives > 1 year => excisional surgery
Reference

Tokuhashi et al. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (2005) vol. 30 (19) pp. 2186-91