cliot (version 1.0.0)

revised_tokuhashi_score: Revised Tokuhashi Score for Metastatic Spine Tumor Prognosis

Description

Calculates the Revised Tokuhashi Score (2005) to estimate the prognosis and guide treatment for patients with metastatic spinal tumors. The score evaluates six parameters: general condition (KPS), number of extraspinal bone metastases, number of vertebral metastases, metastases to major internal organs, primary site of cancer, and spinal cord palsy severity.

Usage

revised_tokuhashi_score(kps, number_extraspinal_bone_mets, number_vertebral_mets,
                        major_organ_metastases, primary_site_group, palsy_frankel)

Value

A list containing:

Tokuhashi_Score

The calculated total score (Range 0-15).

Prognosis

Estimated life expectancy (<6 months, >=6 months, >=1 year).

Treatment_Recommendation

Suggested surgical or conservative approach based on prognosis.

Arguments

kps

Numeric. Karnofsky Performance Status score (0-100). <50: 0 pts. 50-70: 1 pt. 80-100: 2 pts.

number_extraspinal_bone_mets

Numeric. Number of extraspinal bone metastases. >=3: 0 pts. 1-2: 1 pt. 0: 2 pts.

number_vertebral_mets

Numeric. Number of metastases in the vertebral body. >=3: 0 pts. 2: 1 pt. 1: 2 pts.

major_organ_metastases

String. Status of metastases to major internal organs (lungs, liver, kidneys, brain). "unremovable": 0 pts. "removable": 1 pt. "none": 2 pts.

primary_site_group

String. The primary cancer site. "lung", "osteosarcoma", "stomach", "bladder", "esophagus", "pancreas": 0 pts. "liver", "gallbladder", "unidentified": 1 pt. "others": 2 pts. "kidney", "uterus": 3 pts. "rectum": 4 pts. "thyroid", "breast", "prostate", "carcinoid": 5 pts.

palsy_frankel

String. Severity of spinal cord palsy based on Frankel Classification. "complete" (Frankel A, B): 0 pts. "incomplete" (Frankel C, D): 1 pt. "none" (Frankel E): 2 pts.

References

Tokuhashi Y, Matsuzaki H, Oda H, Oshima M, Ryu J. A revised scoring system for preoperative evaluation of metastatic spine tumor prognosis. Spine (Phila Pa 1976). 2005;30(19):2186-2191. doi:10.1097/01.brs.0000180401.06919.a5

Examples

# Example 1: Poor Prognosis
# KPS 40 (0), 3 Extraspinal (0), 3 Vertebral (0),
#Unremovable Organ Mets (0), Lung CA (0), Complete Palsy (0)
# Score = 0
revised_tokuhashi_score(40, 3, 3, "unremovable", "lung", "complete")

# Example 2: Good Prognosis
# KPS 90 (2), 0 Extraspinal (2), 1 Vertebral (2), No Organ Mets (2), Breast CA (5), No Palsy (2)
# Score = 15
revised_tokuhashi_score(90, 0, 1, "none", "breast", "none")