title: Evaluation and modification of the Tomita score in 217 patients with vertebral metastases.
abstract: BACKGROUND
  The Tomita prognosis score consists of the following 3 parameters: growth behavior, evidence of visceral metastases, and/or evidence of bony metastases.
  
  
  METHODS
  217 consecutive patients, surgically treated for vertebral metastases of different entities, were studied retrospectively. The score according to Tomita was determined.
  
  
  RESULTS
  In the study group, the Tomita score showed significant results for the estimation of life expectancy of the different prognostic groups (p < 0.0001), but the analysis showed a low reliability, i.e. correlation between predicted prognosis and real survival. A modified division of the patients based on the total sum of points allowed a significant separation (p < 0.0001) of patients into 2 prognostic groups with a real survival of more or less than 12 months.
  
  
  CONCLUSIONS
  In our study, the original Tomita score was not reliable to predict the life expectancy of cancer patients with spinal metastases. Our modification allows a significant differentiation of patients with spinal metastases with a prognosis of more or less than 12 months.
authors.affiliation: Department of Orthopedics, University of Ulm, Germany. benjamin.ulmar@medizin.uni-ulm.de
authors.forename: Benjamin
authors.initials: B
authors.lastname: Ulmar
authors.forename: Heiko
authors.initials: H
authors.lastname: Reichel
authors.forename: Sibel
authors.initials: S
authors.lastname: Catalkaya
authors.forename: Ulrike
authors.initials: U
authors.lastname: Naumann
authors.forename: René
authors.initials: R
authors.lastname: Schmidt
authors.forename: Susanne
authors.initials: S
authors.lastname: Gerstner
authors.forename: Klaus
authors.initials: K
authors.lastname: Huch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011379:Prognosis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D013125:Spinal Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000556:secondary* / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate