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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

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Which one is a valuable surrogate for predicting survival between Tomita and Tokuhashi scores in patients with spinal metastases? A meta-analysis for diagnostic test accuracy and individual participant data analysis

Meeting Abstract

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  • Chang-Hyun Lee - Department of Neurosurgery, Ilsan Paik Hospital, Inje University, Republic of Korea
  • Chun Kee Chung - Seoul National University Hospital, Seoul National University College of medicine, Republic of Korea
  • Tae-Ahn Jahng - Seoul National University Bundang Hospital, Seoul National University College of medicine, Republic of Korea
  • Ki-Jeong Kim - Seoul National University Bundang Hospital, Seoul National University College of medicine, Republic of Korea
  • Chi Heon Kim - Seoul National University Hospital, Seoul National University College of medicine, Republic of Korea
  • Seung-Jae Hyun - Seoul National University Bundang Hospital, Seoul National University College of medicine, Republic of Korea
  • Hyun-Jib Kim - Seoul National University Bundang Hospital, Seoul National University College of medicine, Republic of Korea
  • Sang Ryong Jeon - Department of Neurological Surgery, Asan Medical Center, University of Ulsan College of Medicine, Republic of Korea
  • Ung-Kyu Chang - Department of Neurosurgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Science, Republic of Korea
  • Sun-Ho Lee - Department of Neurosurgery and Spine Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Republic of Korea
  • Seong-Hwan Moon - Department of Orthopaedic Surgery, Severance Hospital, Yonsei University College of Medicine, Republic of Korea
  • Haroon Majeed - University Hospital of North Staffordshire, Stoke-on-Trent, UK
  • Dan Zhang - Spine Tumor Center, Changzheng Hospital, Second Military Medical University, Shanghai, China
  • Gwenaelle Gravis - Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
  • Christine Wibmer - Department of Orthopaedic Surgery, Medical University of Graz, Graz, Austria
  • Naresh Kumar - Department of Orthopaedic Surgery, University Orthopaedics, Hand and Reconstructive Microsurgery Cluster, National University Hospital, Singapore, Singapore
  • Kyung Yun Moon - Ansan 21th Century Hospital, Department of Neurosurgery, Ansan, Republic of Korea
  • Jin Hoon Park - Gangneung Asan Hospital, Department of Neurological Surgery, Gangneung, Republic of Korea
  • Emeline Tabouret - Department of Medical Oncology, Institut Paoli Calmettes, Marseille, France
  • Stephane Fuentes - Department of Neurosurgery, APHM, Hopital de la Timone, Marseille, France

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMO.13.09

doi: 10.3205/16dgnc073, urn:nbn:de:0183-16dgnc0733

Veröffentlicht: 8. Juni 2016

© 2016 Lee et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

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Text

Objective: This study is to estimate the diagnostic accuracy of Tokuhashi and Tomita scores that assures 6-month predicting survival regarded as a standard of surgical treatment.

Method: We searched PubMed, EMBASE, European PubMed central, and the Cochrane library for papers about the sensitivities and specificities of the Tokuhashi and/or Tomita scores to estimate predicting survival. Studies with cut-off values of = 9 for Tokuhashi and = 7 for Tomita scores based on prior studies were enrolled. Sensitivity, specificity, diagnostic odds ratio (DOR), area under the curve (AUC), and the best cut-off value were calculated via meta-analysis and individual participant data analysis.

Results: Finally, 22 studies were enrolled in the meta-analysis, and 1095 patients from 8 studies were included in the individual data analysis. In the meta-analysis, the pooled sensitivity/specificity/DOR for 6-month survival were 57.7%/76.6%/4.70 for the Tokuhashi score and 81.8%/47.8%/4.93 for Tomita score. The AUC of summary receiver operating characteristic plots was 0.748 for the Tokuhashi score and 0.714 for the Tomita score. Although Tokuhashi score was more accurate than Tomita score slightly, both showed low accuracy to predict 6 months residual survival. Moreover, the best cut-off values of Tokuhashi and Tomita scores were 8 and 6, not 9 and 7, for predicting 6-month survival, respectively.

Conclusions: Estimation of 6-month predicting survival to decide surgery in patients with spinal metastasis is quite limited by using Tokuhashi and Tomita scores alone. Tokuhashi and Tomita scores could be incorporated as part of a multidisciplinary approach or perhaps interpreted in the context of a multidisciplinary approach.