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JRPMS Vol 7, No 3, September 2023, p.82-88

doi: 10.22540/JRPMS-07-082


Review Article

Is it necessary to revise the metastatic spine surgery scores for lung cancer?

Maroula T. Paraforou1, Christos P. Zafeiris2,3

  1. Postgraduate Program “Metabolic Bone Diseases”, National and Kapodistrian University of Athens, Medical School, Athens, Greece
  2. Laboratory for Research of Musculoskeletal System “Theodoros Garofalidis”, National and Kapodistrian University of Athens, KAT Hospital, Athens, Greece
  3. Orthopaedics and Spine Surgery, Metropolitan General Hospital, Athens, Greece

Keywords: Lung Cancer, Prognostic Scores, Spine Metastases, Surgery Scores, Tokuhashi Score


Lung cancer and lung cancer related metastatic spine disease had for many years a poor prognosis. However, after the introduction of molecule targeted agents into the treatment of lung cancer the survival has been prolonged. The prognostic scores, mainly represented by the revised Tokuhashi Score, that have been used in the last decades to predict the survival of the patients and guide the choice of the optimal treatment, classify the patients into short term (<6 months), intermediate (6-12 months) and long term (>12 months) survivors and recommend conservative or surgical treatment accordingly. These scores have not been revised lately and there is a great concern that this improvement in survival of lung cancer patients is not reflected in the calculated scores. This is a review of the literature concerning the accuracy and validity of the current metastatic spine surgery scores in relation to lung cancer derived spinal metastases. Broad consensus exists about the need to revise the current scores and develop new ones specifically for lung cancer.