Comparison of Rades score and Tomita score in predicting the prognosis of patients with spinal metastasis
Objective To compare the accuracy of Rades score and Tomita score in predicting the clinical prognosis of patients with spinal metastases.Methods A total of 127 patients with spinal metastases admitted to the Department of Orthopaedics of the First People's Hospital of Yibin from January 2010 to December 2020 were reviewed.Their medical records were collected and followed up to June 30,2022.Rades score and Tomita score were calculated.Kaplan-Meier method was used to draw the survival curve.Log-rank test and Cox regression were used to analyze the factors affecting the prognosis of patients.Results The median survival time of the patients was 10 months,with a mortality rate of 76.38%(97/127)during the follow-up period.The 6-month and 12-month survival rates were 69.29%and 27.56%,respectively.The average survival time of patients with Rades scores of 20 to 30,31 to 35,and≥36 was(7.0±2.6),(11.7±2.3),and(17.7±4.7)months,respectively.The survival time of patients with Tomita scores of 2 to 3,4 to 5,6 to 7,and 8 to 9 was(18.5±4.7),(11.9±2.2),(8.4±3.0),and(5.5±1.5)months,respectively.The area under the receiver operating characteristic curve predicted by Rades score and Tomita score was 0.931 and 0.928,respectively,with the best cut-off values at 36.5 and 4.5.Cox regression showed that the Rades score,primary tumor type,freedom of movement before treatment,presence or absence of visceral metastasis,and time from tumor diagnosis to spinal metastasis were influencing factors for the prognosis of spinal metastasis.The Rades scores of 20 to 30 and 31 to 35(compared to Rades score≥36)were 41.871 and 4.728,respectively.The HR of lung cancer and other cancers relative to myeloma/lymphoma was 10.039 and 8.475,respectively,and the HR of freedom of movement before treatment was 0.703.The HR without visceral metastasis was 0.606,and the HR for tumors diagnosed with spinal metastasis>15 months was 0.496(P<0.05).The Tomita score and KPS score were related to survival time of patients.The HR for Tomita scores of 4 to 5,6 to 7,and 8 to 9(compared to 2 to 3)were 8.506,25.284,and 84.590,respectively.The HR for KPS scores of 50 to 70 and≥80(compared to≤40)were 0.226 and 0.129,respectively.Conclusions Patients with spinal metastasis have poor prognosis,and the Rades score and Tomita score have certain value in predicting patient prognosis,which can serve as a reference to select treatment methods.
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