BACKGROUND Prognostic scores have been proposed to guide the treatment of patients with metastatic spine disease (MSD), but their accuracy and usefulness are controversial. The aim of this study was to evaluate seven such prognostic scoring systems. The following prognostic scores were compared: Tomita, Van der Linden (VDL), Bauer modified (BM), Oswestry Spinal Risk Index (OSRI), Tokuhashi original (T90), Tokuhashi revised (TR05), and modified Tokuhashi revised (TR17). METHODS We retrospectively reviewed all our patients who underwent surgery for spinal metastases, February 2008-January 2015. We classified all 223 patients into the predicted survival-time categories of each of the 7 scoring systems and then tallied how often this was correct vis-à-vis the actual survival time. Accuracy was also assessed using receiver operating characteristic (ROC) analysis at 1, 3, and 12 months. RESULTS The median (95% CI) survival of the 223 patients was 13.6 (7.9-19.3) months. A groupwise ROC analysis showed sufficient accuracy for 3-month survival only for TR17 (area under the curve [AUC] 0.71) and for 1-year survival for T90 (AUC 0.73), TR05 (AUC 0.76), TR17 (AUC 0.76), Tomita (AUC 0.77), and OSRI (AUC 0.71). A pointwise ROC score analysis showed poor prognostic ability for short-term survival (1 and 3 months) with sufficient accuracy for T90 (AUC 0.71), TR05 (AUC 0.71), TR17 (AUC 0.71), and the Tomita score (AUC 0.77) for 1-year survival. CONCLUSION The TR17 was the only prognostic system with acceptable performance here. More sophisticated assessment tools are required to keep up with present and future changes in tumor diagnostics and treatment.

中文翻译：

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手术治疗的硬膜外转移性脊柱疾病患者的七个预后评分分析。

背景技术已经提出了预后评分来指导转移性脊柱疾病（MSD）患者的治疗，但是其准确性和有效性尚存争议。这项研究的目的是评估七个这样的预后评分系统。比较以下预后评分：Tomita，Van der Linden（VDL），Bauer修正（BM），Oswestry脊柱风险指数（OSRI），Tokuhashi原始（T90），Tokuhashi修正（TR05）和Tokuhashi修正（TR17）。方法我们回顾性分析了2008年2月至2015年1月所有因脊柱转移瘤接受手术治疗的患者。我们将223例患者分为7个评分系统中的每个患者的预计生存时间类别，然后对与à-à -相对于实际生存时间。还使用接收器工作特性（ROC）分析在1、3和12个月时评估了准确性。结果223例患者的中位生存期（95％CI）为13.6（7.9-19.3）个月。分组ROC分析显示，仅TR17（曲线下面积[AUC] 0.71）的3个月生存率和T90（AUC 0.73），TR05（AUC 0.76），TR17（AUC 0.76）的1年生存率具有足够的准确性，富田（AUC 0.77）和OSRI（AUC 0.71）。逐点ROC评分分析显示短期存活（1和3个月）的预后能力较差，对于T90（AUC 0.71），TR05（AUC 0.71），TR17（AUC 0.71）和Tomita评分（AUC 0.77）具有足够的准确性1年生存。结论TR17是唯一具有可接受性能的预后系统。