AB077. An evaluation of prognostic scoring systems for survival in a surgically treated cohort of 318 metastatic spine tumour surgery patients
Abstract

AB077. An evaluation of prognostic scoring systems for survival in a surgically treated cohort of 318 metastatic spine tumour surgery patients

Si Jian Hui1, Naresh Kumar1, Eugene Chua2, Cherie Lin Hui Tan2, Xinyi Lim1, James Hallinan1, Yiong Huak Chan3, Jiong Hao Tan1

1University Spine Centre, Department of Orthopaedic Surgery, National University Health System, Singapore, Singapore; 2Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore; 3National University Singapore Medicine Biostatistics Unit, Singapore, Singapore

Correspondence to: Naresh Kumar, MBBS, M.S. (Orth), D.N.B. (Orth), FRCS (Trauma and Orth), DM (Orth and Spinal Surgery). University Spine Centre, Department of Orthopaedic Surgery, National University Health System, 1E Kent Ridge Rd., Singapore 119228, Singapore. Email: dosksn@nus.edu.sg.

Background: Survival prognostication plays a key role in the decision-making process for the surgical treatment of patients with spinal metastases. In the past traditional scoring systems such as the modified Tokuhashi and Tomita scoring systems have been used extensively, however in recent years their accuracy has been called into question. This has led to the development of machine learning algorithms to predict survival. In this study, we aim to compare the accuracy of prognostic scoring systems in a surgically treated cohort of patients.

Methods: This is a retrospective review of 318 surgically treated spinal metastases patients between 2009 and 2021. The primary outcome measured was survival from the time of diagnosis. Predicted survival at 3 months, 6 months and 1 year based on the prognostic scoring system was compared to actual survival. Predictive values of each scoring system were measured via area under receiver operating characteristic curves (AUROC). The following scoring systems were compared, Modified Tokuhashi (MT), Tomita (T), Modified Bauer (MB), Van Den Linden (VDL), Oswestry (O), New England Spinal Metastases score (NESMS), Global Spine Study Tumor Group (GSTSG) and Skeletal Oncology Research Group (SORG) scoring systems.

Results: For predicting 3 months survival, the GSTSG 0.980 (0.949–1.0) and NESM 0.980 (0.949–1.0) had outstanding predictive value, while the SORG 0.837 (0.751–0.923) and O 0.837 (0.775–0.900) had excellent predictive value. While for 6 months survival, only the O 0.819 (0.758–0.880) had excellent predictive value and the GSTSG 0.791(0.725–0.857) had acceptable predictive value. For 1 year survival, the NESM 0.871 (0.822–0.919) had excellent predictive value and the O 0.722 (0.657–0.786) had acceptable predictive value. The MT, T and MB scores had an area under the curve (AUC) of <0.5 for 3-month, 6-month and 1-year survival.

Conclusions: Increasingly, traditional scoring systems such as the MT, T and MB scoring systems have become less predictive. While newer scoring systems such as the GSTSG, NESM and SORG have outstanding to excellent predictive value, there is no one survival scoring system that is able to accurately prognosticate survival at all 3 time points. A multidisciplinary, personalised approach to survival prognostication is needed.

Keywords: Metastatic spine tumour surgery (MSTS); prognostic scoring; survival

Acknowledgments

Funding: None.

Footnote

Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://cco.amegroups.com/article/view/10.21037/cco-24-ab077/coif). The authors have no conflicts of interest to declare.

Ethical Statement: The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance to the Declaration of Helsinki (as revised in 2013) and approved by National Healthcare Group Domain Specific Review Board (Singapore) DSRB Ref: 2020/00835. A waiver of consent was granted due to the retrospective nature of the study and the minimal risk involved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the noncommercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Cite this abstract as: Hui SJ, Kumar N, Chua E, Tan CLH, Lim X, Hallinan J, Chan YH, Tan JH. AB077. An evaluation of prognostic scoring systems for survival in a surgically treated cohort of 318 metastatic spine tumour surgery patients. Chin Clin Oncol 2024;13(Suppl 1):AB077. doi: 10.21037/cco-24-ab077

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