title: STUDY ON THE APPLICABILITY OF THE MODIFIED TOKUHASHI SCORE IN PATIENTS WITH SURGICALLY TREATED VERTEBRAL METASTASIS.
abstract: To present the results obtained from surgical treatment of patients with vertebral metastases, comparing them with the modified Tokuhashi score in order to validate the applicability of this score for prognostic predictions and for choosing surgical treatments.
  
  
  METHODS
  This was a retrospective study on 157 patients treated surgically for spinal metastasis in Erastus Gaertner Hospital in Curitiba. The Tokuhashi score was applied retrospectively to all the patients. The patients' actual survival time was compared with the expected survival time using the Tokuhashi score.
  
  
  RESULTS
  There were 82 females and 75 males. The most frequent location of the primary tumor was the breast. The thoracic region was involved in 66.2%, lumbar region in 65.6%, cervical region in 15.9% and sacral region in 12.7%. All the patients underwent surgical treatment. The most frequent indication for treatment was intractable pain (89.2%). There was partial or complete improvement in a majority of the cases (52.2%). Out of 157 cases studied, 86.6% died. The maximum survival time was 13.6 years, the minimum was 3 days and the mean was 13.2 months. The following frequencies of Tokuhashi scores were found among the operated cases: up to 8 points, 111 cases; 9-11 points, 43 cases; and 12-15 points, three cases. The mean survival time in months for all 157 patients according to the Tokuhashi score was: 0-8 points, 15.4 months; 9-11 points, 11.4 months; and 12-15 points, 12 months.
  
  
  CONCLUSIONS
  Unlike the nonsurgical approach recommended by Tokuhashi for patients with lower scores, this group in our study was sent for surgery, with better results than those of non-operated patients reported by Tokuhashi.
authors.affiliation: General Surgeon. Oncological Surgery Residents at Hospital Erasto Gaertner, Curitiba, PR, Brazil.
authors.forename: Jeferson Luis
authors.initials: JL
authors.lastname: Mattana
authors.affiliation: General Surgeon. Oncological Surgery Residents at Hospital Erasto Gaertner, Curitiba, PR, Brazil.
authors.forename: Rosyane Rena de
authors.initials: RR
authors.lastname: Freitas
authors.affiliation: Orthopedist in the Oncological Orthopedics Service, Hospital Erasto Gaertner, Curitiba, PR, Brazil.
authors.forename: Glauco José Pauka
authors.initials: GJ
authors.lastname: Mello
authors.affiliation: Orthopedist in the Oncological Orthopedics Service, Hospital Erasto Gaertner, Curitiba, PR, Brazil.
authors.forename: Mário Armani
authors.initials: MA
authors.lastname: Neto
authors.affiliation: Orthopedist in the Oncological Orthopedics Service, Hospital Erasto Gaertner, Curitiba, PR, Brazil.
authors.forename: Geraldo de
authors.initials: Gd
authors.lastname: Freitas Filho
authors.affiliation: Orthopedist in the Oncological Orthopedics Service, Hospital Erasto Gaertner, Curitiba, PR, Brazil.
authors.forename: Carolina Bega
authors.initials: CB
authors.lastname: Ferreira
authors.affiliation: Medical Students at PUC, Curitiba, PR, Brazil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Novaes
keywords: Neoplasm Metastasis; Spine; Survivorship (Public Health)