title: The Tokuhashi score: significant predictive value for the life expectancy of patients with breast cancer with spinal metastases.
abstract: METHODS
  Retrospective study of 55 consecutive patients with spinal metastases secondary to breast cancer who underwent surgery.
  
  
  OBJECTIVE
  To evaluate the predictive value of the Tokuhashi score for life expectancy in patients with breast cancer with spinal metastases.
  
  
  BACKGROUND
  The score, composed of 6 parameters each rated from 0 to 2, has been proposed by Tokuhashi and colleagues for the prognostic assessment of patients with spinal metastases.
  
  
  METHODS
  A total of 55 patients surgically treated for vertebral metastases secondary to breast cancer were studied. The score was calculated for each patient and, according to Tokuhashi, the patients were divided into 3 groups with different life expectancy according to their total number of scoring points. In a second step, the grouping for prognosis was modified to get a better correlation of the predicted and definitive survival.
  
  
  RESULTS
  Applying the Tokuhashi score for the estimation of life expectancy of patients with breast cancer with vertebral metastases provided very reliable results. However, the original analysis by Tokuhashi showed a limited correlation between predicted and real survival for each prognostic group. Therefore, our patients were divided into modified prognostic groups regarding their total number of scoring points, leading to a higher significance of the predicted prognosis in each group (P < 0.0001), and a better correlation of the predicted and real survival.
  
  
  CONCLUSIONS
  The modified Tokuhashi score assists in decision making based on reliable estimators of life expectancy in patients with spinal metastases secondary to breast cancer.
authors.affiliation: Department of Orthopedic Surgery and Spinal Cord Injury, University of Ulm, Ulm, Germany.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ulmar
authors.forename: Marcus
authors.initials: M
authors.lastname: Richter
authors.forename: Balkan
authors.initials: B
authors.lastname: Cakir
authors.forename: Rainer
authors.initials: R
authors.lastname: Muche
authors.forename: Wolfhart
authors.initials: W
authors.lastname: Puhl
authors.forename: Klaus
authors.initials: K
authors.lastname: Huch
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008017:Life Expectancy; D019637:Orthopedic Procedures; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000503:physiopathology* / Q000556:secondary* / Q000601:surgery; D016019:Survival Analysis