The Tokuhashi score, a prognostic tool used to estimate survival and guide treatment decisions for patients with spinal metastases, based on survival estimates and tumor characteristics.
| Parameter | Score options |
|---|---|
| General condition (Karnofsky Performance Status) | Poor (10–40%) = 0Moderate (50–70%) = 1Good (80–100%) = 2 |
| Number of extraspinal bone metastases | ≥ 3 = 01–2 = 10 = 2 |
| Number of metastases in the vertebral body | ≥ 3 = 02 = 11 = 2 |
| Metastases to major internal organs | Non-removable = 0Removable = 1None = 2 |
| Primary site of cancer | Lung, osteosarcoma, stomach, bladder, esophagus, pancreas = 0Liver, gallbladder, unidentified = 1Other cancers = 2Kidney, uterus = 3Rectum = 4Thyroid, prostate, breast, carcinoid tumor = 5 |
| Neurological status (Frankel classification) | Frankel A, B = 0Frankel C, D = 1Frankel E = 2 |
Interpretation: total score range: 0–15. Prognostic guidance: 0–8 points: predicted survival is generally less than 6 months, and conservative or palliative management is usually considered; 9–11 points: predicted survival is approximately 6–12 months, and selected patients may be considered for surgical intervention; 12–15 points: predicted survival is more than 1 year, and surgical treatment may be appropriate in suitable candidates.
OA: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. M Subih: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. LS: Conceptualization, Investigation, Formal analysis, Writing—original draft. M Stublla: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. DB: Writing—review & editing. PT: Conceptualization, Investigation, Formal analysis, Writing—original draft, Data curation, Writing—review & editing. OS: Writing—review & editing. AEEAE: Writing—review & editing. All authors read and approved the submitted version.
Patricia Tai, who is the Editorial Board Member and Guest Editor of Exploration of Medicine, and Omar Alqaisi, who is the Guest Editor of Exploration of Medicine, had no involvement in the decision-making or the review process of this manuscript. The other authors declare no conflicts of interest.
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