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

doi:10.1007/s00586-015-3862-9

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

^*Corresponding author for this work

Neurological Surgery

Research output: Contribution to journal › Article › peer-review

12 Scopus citations

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 language	English (US)
Pages (from-to)	2142-2149
Number of pages	8
Journal	European Spine Journal
Volume	24
Issue number	10
DOIs	https://doi.org/10.1007/s00586-015-3862-9
State	Published - Oct 1 2015

Funding

RJP, SMS, JR, PLZ, RSE, MLG, and JPW have no disclosures. CRG is a UNCF Merck Postdoctoral Fellow and has received an award from the Burroughs Wellcome Fund. AB is the recipient of a research grant from DePuy Spine and serves on the clinical advisory board of MedImmune, LLC. TW is a recipient of a research grant from Eli Lilly and Company. ZG has disclosures of stock ownership in US Spine and Spinal Kinetics, consulting, speaking and teaching for the AO Foundation and Research support from Depuy, NREF, AOSpine and AO North America. DS is a consultant for DePuy, Medtronic, Nuvasive, and Globus. The authors report no external source of funding. The corresponding author had full access to all data in this study and has final responsibility for the decision to submit for publication.

Keywords

Metastatic
Renal cell carcinoma
Spine
Surgery
Tokuhashi score

ASJC Scopus subject areas

Surgery
Orthopedics and Sports Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Petteys, R. J., Spitz, S. M., Rhee, J., Rory Goodwin, C., Zadnik, P. L., Sarabia-Estrada, R., Groves, M. L., Bydon, A., Witham, T. F., Wolinsky, J. P., Gokaslan, Z. L., & Sciubba, D. M. (2015). Tokuhashi score is predictive of survival in a cohort of patients undergoing surgery for renal cell carcinoma spinal metastases. European Spine Journal, 24(10), 2142-2149. https://doi.org/10.1007/s00586-015-3862-9

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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.",

keywords = "Metastatic, Renal cell carcinoma, Spine, Surgery, Tokuhashi score",

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

note = "Publisher Copyright: {\textcopyright} 2015, Springer-Verlag Berlin Heidelberg.",

year = "2015",

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doi = "10.1007/s00586-015-3862-9",

language = "English (US)",

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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

TY - JOUR

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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U2 - 10.1007/s00586-015-3862-9

DO - 10.1007/s00586-015-3862-9

M3 - Article

C2 - 25772089

AN - SCOPUS:84957838961

SN - 0940-6719

VL - 24

SP - 2142

EP - 2149

JO - European Spine Journal

JF - European Spine Journal

IS - 10

ER -

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

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