Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases

Rory J. Petteys, Steven M. Spitz, Jay Rhee, C. Rory Goodwin, Patricia L. Zadnik, Rachel Sarabia Estrada, Mari L. Groves, Ali Bydon, Timothy F. Witham, Jean Paul Wolinsky, Ziya L. Gokaslan, Daniel M. Sciubba

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Purpose: Renal cell carcinoma (RCC) is an aggressive disease that metastasizes to the spine often requiring surgery. However, selecting the appropriate surgical intervention can be challenging. The Tokuhashi scoring system can be used to predict survival and inform the surgical strategy. We set out to determine the Tokuhashi score for patients with RCC spine metastases and compare expected and observed survival. Methods: Records were reviewed for all patients who underwent surgery for spinal metastases at a single institution from January 2000 to December 2011 to determine the Tokuhashi score and survival. Kaplan–Meier estimates and log-rank test for univariate analysis were performed with R version 2.15.12 (R Foundation, 2012). Results: Thirty patients underwent 40 spinal operations for metastatic RCC. Median survival was 11.4 months. Preoperative Tokuhashi scores were: 12–15, 15 patients; 9–11, seven patients; 0–8, eight patients. Median survival was 32.9, 11.7, and 5.4 months, respectively. Bone (p = 0.01) and visceral metastases (p = 0.005), and KPS (p = 0.002) significantly affected survival. Tokuhashi score predicted survival (p = 0.016); survival differed between the high and low score groups (p = 0.006). Conclusions: RCC is an aggressive disease with short life expectancy when metastatic to the spine. However, patients with low systemic disease burden and solitary spinal metastases can have long survival and benefit from excisional surgery. Tokuhashi score can be useful in selecting surgical intervention in patients with RCC spinal metastases, and may be more relevant than in other cancers with spinal metastases.

Original languageEnglish (US)
Pages (from-to)2142-2149
Number of pages8
JournalEuropean Spine Journal
Volume24
Issue number10
DOIs
StatePublished - Oct 1 2015
Externally publishedYes

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Renal Cell Carcinoma
Neoplasm Metastasis
Survival
Spine
Life Expectancy
Bone and Bones

Keywords

  • Metastatic
  • Renal cell carcinoma
  • Spine
  • Surgery
  • Tokuhashi score

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine
  • Medicine(all)

Cite this

Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases. / Petteys, Rory J.; Spitz, Steven M.; Rhee, Jay; Rory Goodwin, C.; Zadnik, Patricia L.; Sarabia Estrada, Rachel; Groves, Mari L.; Bydon, Ali; Witham, Timothy F.; Wolinsky, Jean Paul; Gokaslan, Ziya L.; Sciubba, Daniel M.

In: European Spine Journal, Vol. 24, No. 10, 01.10.2015, p. 2142-2149.

Research output: Contribution to journalArticle

Petteys, RJ, Spitz, SM, Rhee, J, Rory Goodwin, C, Zadnik, PL, Sarabia Estrada, R, Groves, ML, Bydon, A, Witham, TF, Wolinsky, JP, Gokaslan, ZL & Sciubba, DM 2015, 'Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases', European Spine Journal, vol. 24, no. 10, pp. 2142-2149. https://doi.org/10.1007/s00586-015-3862-9
Petteys, Rory J. ; Spitz, Steven M. ; Rhee, Jay ; Rory Goodwin, C. ; Zadnik, Patricia L. ; Sarabia Estrada, Rachel ; Groves, Mari L. ; Bydon, Ali ; Witham, Timothy F. ; Wolinsky, Jean Paul ; Gokaslan, Ziya L. ; Sciubba, Daniel M. / Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases. In: European Spine Journal. 2015 ; Vol. 24, No. 10. pp. 2142-2149.
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title = "Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases",
abstract = "Purpose: Renal cell carcinoma (RCC) is an aggressive disease that metastasizes to the spine often requiring surgery. However, selecting the appropriate surgical intervention can be challenging. The Tokuhashi scoring system can be used to predict survival and inform the surgical strategy. We set out to determine the Tokuhashi score for patients with RCC spine metastases and compare expected and observed survival. Methods: Records were reviewed for all patients who underwent surgery for spinal metastases at a single institution from January 2000 to December 2011 to determine the Tokuhashi score and survival. Kaplan–Meier estimates and log-rank test for univariate analysis were performed with R version 2.15.12 (R Foundation, 2012). Results: Thirty patients underwent 40 spinal operations for metastatic RCC. Median survival was 11.4 months. Preoperative Tokuhashi scores were: 12–15, 15 patients; 9–11, seven patients; 0–8, eight patients. Median survival was 32.9, 11.7, and 5.4 months, respectively. Bone (p = 0.01) and visceral metastases (p = 0.005), and KPS (p = 0.002) significantly affected survival. Tokuhashi score predicted survival (p = 0.016); survival differed between the high and low score groups (p = 0.006). Conclusions: RCC is an aggressive disease with short life expectancy when metastatic to the spine. However, patients with low systemic disease burden and solitary spinal metastases can have long survival and benefit from excisional surgery. Tokuhashi score can be useful in selecting surgical intervention in patients with RCC spinal metastases, and may be more relevant than in other cancers with spinal metastases.",
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T1 - Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases

AU - Petteys, Rory J.

AU - Spitz, Steven M.

AU - Rhee, Jay

AU - Rory Goodwin, C.

AU - Zadnik, Patricia L.

AU - Sarabia Estrada, Rachel

AU - Groves, Mari L.

AU - Bydon, Ali

AU - Witham, Timothy F.

AU - Wolinsky, Jean Paul

AU - Gokaslan, Ziya L.

AU - Sciubba, Daniel M.

PY - 2015/10/1

Y1 - 2015/10/1

N2 - Purpose: Renal cell carcinoma (RCC) is an aggressive disease that metastasizes to the spine often requiring surgery. However, selecting the appropriate surgical intervention can be challenging. The Tokuhashi scoring system can be used to predict survival and inform the surgical strategy. We set out to determine the Tokuhashi score for patients with RCC spine metastases and compare expected and observed survival. Methods: Records were reviewed for all patients who underwent surgery for spinal metastases at a single institution from January 2000 to December 2011 to determine the Tokuhashi score and survival. Kaplan–Meier estimates and log-rank test for univariate analysis were performed with R version 2.15.12 (R Foundation, 2012). Results: Thirty patients underwent 40 spinal operations for metastatic RCC. Median survival was 11.4 months. Preoperative Tokuhashi scores were: 12–15, 15 patients; 9–11, seven patients; 0–8, eight patients. Median survival was 32.9, 11.7, and 5.4 months, respectively. Bone (p = 0.01) and visceral metastases (p = 0.005), and KPS (p = 0.002) significantly affected survival. Tokuhashi score predicted survival (p = 0.016); survival differed between the high and low score groups (p = 0.006). Conclusions: RCC is an aggressive disease with short life expectancy when metastatic to the spine. However, patients with low systemic disease burden and solitary spinal metastases can have long survival and benefit from excisional surgery. Tokuhashi score can be useful in selecting surgical intervention in patients with RCC spinal metastases, and may be more relevant than in other cancers with spinal metastases.

AB - Purpose: Renal cell carcinoma (RCC) is an aggressive disease that metastasizes to the spine often requiring surgery. However, selecting the appropriate surgical intervention can be challenging. The Tokuhashi scoring system can be used to predict survival and inform the surgical strategy. We set out to determine the Tokuhashi score for patients with RCC spine metastases and compare expected and observed survival. Methods: Records were reviewed for all patients who underwent surgery for spinal metastases at a single institution from January 2000 to December 2011 to determine the Tokuhashi score and survival. Kaplan–Meier estimates and log-rank test for univariate analysis were performed with R version 2.15.12 (R Foundation, 2012). Results: Thirty patients underwent 40 spinal operations for metastatic RCC. Median survival was 11.4 months. Preoperative Tokuhashi scores were: 12–15, 15 patients; 9–11, seven patients; 0–8, eight patients. Median survival was 32.9, 11.7, and 5.4 months, respectively. Bone (p = 0.01) and visceral metastases (p = 0.005), and KPS (p = 0.002) significantly affected survival. Tokuhashi score predicted survival (p = 0.016); survival differed between the high and low score groups (p = 0.006). Conclusions: RCC is an aggressive disease with short life expectancy when metastatic to the spine. However, patients with low systemic disease burden and solitary spinal metastases can have long survival and benefit from excisional surgery. Tokuhashi score can be useful in selecting surgical intervention in patients with RCC spinal metastases, and may be more relevant than in other cancers with spinal metastases.

KW - Metastatic

KW - Renal cell carcinoma

KW - Spine

KW - Surgery

KW - Tokuhashi score

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