Open AccessEvaluation of different scoring systems for spinal metastases based on a Chinese cohort
Author(s) -
Li Zhehuang,
Guo Liangyu,
Guo Bairu,
Zhang Peng,
Wang Jiaqiang,
Wang Xin,
Yao Weitao
Publication year - 2023
Publication title -
cancer medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.403
H-Index - 53
ISSN - 2045-7634
DOI - 10.1002/cam4.5272
Subject(s) - nomogram , medicine , receiver operating characteristic , scoring system , survival analysis , area under the curve , overall survival , area under curve , cohort , retrospective cohort study , single center , oncology , surgery , pharmacokinetics
s The spine is one of the most common sites of metastasis for malignancies. This study aimed to compare the predictive performance of seven commonly used prognostic scoring systems for surgically treated spine metastases. It is expected to assist surgeons in selecting appropriate scoring systems to support clinical decision‐making and better inform patients. Methods We performed a retrospective study involving 268 surgically treated patients with spine metastases between 2017 and 2020 at a single regional oncology center in China. The revised Tokuhashi, Tomita, modified Bauer, revised Katagiri, van der Linden, Skeletal Oncology Research Group (SORG) nomogram, and SORG machine‐learning (ML) scoring systems were externally validated. The area under the curve (AUC) of the receiver operating characteristic curve was used to evaluate sensitivity and specificity at different postoperative time points. The actual survival time was compared with the reference survival time provided in the original publication. Results In the present study, the median survival was 16.6 months. The SORG ML scoring system demonstrated the highest accuracy in predicting 90‐day (AUC: 0.743) and 1‐year survival (AUC: 0.787). The revised Katagiri demonstrated the highest accuracy (AUC: 0.761) in predicting 180‐day survival. The revised Katagiri demonstrated the highest accuracy (AUC: 0.779) in predicting 2‐year survival. Based on this series, the actual life expectancy was underestimated compared with the original reference survival time. Conclusions None of the scoring systems can perform optimally at all time points and for all pathology types, and the reference survival times provided in the original study need to be updated. A cautious awareness of the underestimation by these models is of paramount importance in relation to current patients.