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转移性脊柱肿瘤预后预测评分系统。

Scoring system for prediction of metastatic spine tumor prognosis.

作者信息

Tokuhashi Yasuaki, Uei Hiroshi, Oshima Masashi, Ajiro Yasumitsu

机构信息

Yasuaki Tokuhashi, Hiroshi Uei, Masashi Oshima, Department of Orthopaedic Surgery, Nihon University School of Medicine, Itabashi-ku, Tokyo 173-8610, Japan.

出版信息

World J Orthop. 2014 Jul 18;5(3):262-71. doi: 10.5312/wjo.v5.i3.262.

Abstract

Assessing the prognosis before treatment for metastatic spine tumor is extremely important in therapy selection. Therefore, we review some prognostic scoring systems and their outcomes. Articles with combinations of two keywords among "metastatic spine tumor" and "prognosis", "score", "scoring system", "predicting", or "life expectancy" were searched for in PubMed. As a result, 236 articles were extracted. Those referring to representative scoring systems about predicting the survival of patients with metastatic spine tumors were used. The significance and limits of these scoring systems, and the future perspectives were described. Tokuhashi score, Tomita score, Baur score, Linden score, Rades score, and Katagiri score were introduced. They are all scoring systems prepared by combining factors that affect prognosis. The primary site of cancer and visceral metastasis were common factors in all of these scoring systems. Other factors selected to influence the prognosis varied. They were useful to roughly predict the survival period, such as, "more than one year or not" or "more than six months or not". In particular, they were utilized for decision-making about operative indications and avoidance of excessive medical treatment. Because the function depended on the survival period in the patients with metastatic spine tumor, it was also utilized in assessing functional prognosis. However, no scoring system had more than 90% consistency between the predicted and actual survival periods. Future perspectives should adopt more oncological viewpoints with adjustment of the process of treatment for metastatic spine tumor.

摘要

在转移性脊柱肿瘤治疗前评估预后对于治疗方案的选择极为重要。因此,我们回顾了一些预后评分系统及其结果。在PubMed中搜索了包含“转移性脊柱肿瘤”与“预后”、“评分”、“评分系统”、“预测”或“预期寿命”这两个关键词组合的文章。结果,共提取出236篇文章。选取了那些提及预测转移性脊柱肿瘤患者生存情况的代表性评分系统的文章。描述了这些评分系统的意义和局限性以及未来展望。介绍了Tokuhashi评分、Tomita评分、Baur评分、Linden评分、Rades评分和Katagiri评分。它们都是通过综合影响预后的因素而制定的评分系统。癌症的原发部位和内脏转移在所有这些评分系统中都是常见因素。其他用于影响预后的所选因素各不相同。它们有助于大致预测生存期,例如“是否超过一年”或“是否超过六个月”。特别是,它们被用于手术指征的决策以及避免过度医疗。由于转移性脊柱肿瘤患者的功能取决于生存期,所以它也被用于评估功能预后。然而,没有一个评分系统在预测生存期和实际生存期之间的一致性超过90%。未来展望应采用更多肿瘤学观点,同时调整转移性脊柱肿瘤的治疗过程。

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