ReviewEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2016
The Tokuhashi score: effectiveness and pitfalls.
Review in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
31 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Prognostic scores for survival as decisional support for surgery in spinal metastases: a performance assessment systematic review.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2021Pooled it
- Research on the predicting power of the revised Tokuhashi system: how much time can surgery give to patients with short life expectancy?International journal of clinical oncology · 2020Trial
- En-Bloc Spondylectomy for spinal metastases: outcomes, indications, and cost analysis in a 40-patient retrospective study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026Article
- Predicting survival of patients with spinal involvement in multiple myeloma using PATHFx 3.0 - a validation study of 100 patients in Germany.World journal of surgical oncology · 2026Article
- Outcomes and Complications of Surgery for Symptomatic Spinal Metastases; a Comparison Between Patients Aged ≥ 70 and <70.Global spine journal · 2025Article
- Six-Month Survivorship Prediction in Spinal Metastatic Patients by Oncologists Shows Reliable Prognostication.Global spine journal · 2025Article
- Tumor markers in non-small cell lung cancer spine metastasis: an assessment of prognosis and overall survival.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2024Article
- A new era in the management of spinal metastasis.Frontiers in oncology · 2024Review
- Nutritional Status Is Associated With Survival Following Spinal Surgery in Patients With Metastatic Spinal Tumors.Cureus · 2023Article
- Trends in Survival and Surgical Methods in Patients Surgically Treated for Metastatic Spinal Tumors: 25-Year Experience in a Single Institution.Clinics in orthopedic surgery · 2023Article
- Establishing the Swiss Spinal Tumor Registry (Swiss-STR): a prospective observation of surgical treatment patterns and long-term outcomes in patients with primary and metastatic spinal tumors.Frontiers in surgery · 2023Review
- Survival and Functional Outcomes after Surgical Treatment for Spinal Metastasis in Patients with a Short Life Expectancy.Journal of clinical medicine · 2022Article
- Clear Cell Renal Cell Carcinoma Spinal Metastases: Which Factors Matter to the Overall Survival? A 10-Year Experience of a High-Volume Tumor Spine Center.Diagnostics (Basel, Switzerland) · 2022Article
- An Updated Review on the Treatment Strategy for Spinal Metastasis from the Spine Surgeon's Perspective.Asian spine journal · 2022Article
- Optimization of Tokuhashi Scoring System to Improve Survival Prediction in Patients with Spinal Metastases.Journal of clinical medicine · 2022Article
- Prognosis after Palliative Surgery for Patients with Spinal Metastasis: Comparison of Predicted and Actual Survival.Cancers · 2022Article
- Prognostic Scoring System Development for Malignant Spinal Cord Compression.Asian Pacific journal of cancer prevention : APJCP · 2022Article
- Machine learning in orthopaedic surgery.World journal of orthopedics · 2021Review
- Treatment Strategy for Metastatic Spinal Tumors: A Narrative Review.Asian spine journal · 2020Article
- Epidemiological Characteristics of 1196 Patients with Spinal Metastases: A Retrospective Study.Orthopaedic surgery · 2019Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeAccurate survival estimation is prerequisite to determine the most appropriate treatment for patients with metastatic spine disease. Several authors have proposed classification systems analyzing clinical and radiological parameters, such as, performance status, metastasis localization, and primary tumor histotype, but the modified Tokuhashi score (mTS) is the most widely used. Although it is regarded as one of the most complete and accurate systems, it does not take the effectiveness of new therapeutic strategies into consideration, contributing to a progressive loss of accuracy. The purpose of this review is to verify the ability of the mTS to accurately estimate metastatic spine patient survival, nearly 10 years after it was introduced.
methodsA literature review was conducted to evaluate mTS accuracy to predict metastatic spine patient survival.
resultsTen studies were selected, representing 1686 patients. The total predictive accuracy of the mTS was 63.00%; for patients expected to survive less than 6 months (group I), it was 64.10%; 6-12 months (group II), 55.32%; and more than 12 months (group III), 77.21%. A progressive decrease in accuracy over time was statistically significant in groups I and II.
conclusionsThe mTS is suggestive of actual survival for patients with a good prognosis. It is less accurate for patients with an estimated survival of less than 12 months. The decreasing trend in mTS accuracy over time will likely further reduce mTS utility. An important opportunity exists to develop new instruments to assist spine surgeons and oncologists to choose appropriate surgical or non-surgical treatment modalities for patients with metastatic spine disease.
Indexed as
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.