Tomita score

Surgical strategy for spinal metastases

Primary tumor

• 1 point: slow growth (e.g. breast, prostate, thyroid)
• 2 points: moderate growth (e.g. kidney, uterus)
• 4 points: rapid growth (e.g. lung, liver, stomach, colon, primary unknown)

Visceral metastases

• 0 points: no visceral metastases
• 2 points: treatable
• 4 points: untreatable

Bone metastases (including spine)

• 1 point: solitary / isolated
• 2 points: multipe

Note: scores for each group are derived from the hazard ratio by rounding off to the nearest integer.

Treatment goal & Surgical strategy

• 2 - 3 points: long-term local control (mean survival 50 months) => wide or marginal excision
• 4 - 5 points: middle-term local control (mean survival 23,5 months) => marginal or intralesional excision
• 6 - 7 points: short-term palliation (mean survival 15 months) => palliative surgery
• 8 - 10 points: terminal care (mean survival 6 months) => supportive care, no surgery

Reference

Tomita et al. Surgical strategy for spinal metastases. Spine (2001) vol. 26 (3) pp. 298-306

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