Tokuhashi score
Metastatic spine tumor prognosis
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. 2186-91Supported by:
