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 1).
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