Modified score based on revised Tokuhashi score is needed for the determination of surgical intervention in patients with lung cancer metastases to the spine

Table 1 Prognostic factor analysis in 120 patients with lung cancer metastases to the spine

Prognostic factor	n*	Kaplan–Meier		Univariate COX regression		Multivariate Cox regression
Prognostic factor	n*	Median OS^Δ	p	HR (95% CI)^◇	p	HR (95% CI) ◇	p
Gender
Female	49	12
Male	71	6	0.1246	1.346 (0.910–1.991)	0.136
Age
≤ 66.5 years	79	10
> 66.5 years	41	6	0.2953	1.226 (0.828–1.814)	0.309
History of smoking
With	90	8
Without	30	7	0.6074	1.115 (0.727–1.712)	0.618
Tumor marker
Normal	41	17
Abnormal	79	6	< 0.0001	2.557 (1.639–3.992)	0.000	2.526 (1.620–3.937)	0.000
ESR
Normal	55	11
Abnormal	65	6	0.7543	1.061 (0.726–1.551)	0.761
ALP
Normal	72	8
Abnormal	48	8	0.4794	1.147 (0.777–1.696)	0.490
LDH
Normal	61	12
Abnormal	59	6	0.0815	1.386 (0.949–2.023)	0.091
Albumin
Normal	53	10
Abnormal	67	6.6	0.6189	1.098 (0.752–1.605)	0.628
Calcium ion
Normal	80	7
Abnormal	40	10	0.3286	0.822 (0.549–1.231)	0.342
Neoplasms histologic type of lung cancer
Adenocarcinoma	97	9.5
Others	23	5	0.5151	1.165 (0.725–1.872)	0.528
The adoption of targeted therapy
With	48	17
Without	72	5.65	< 0.0001	2.231 (1.487–3.347)	0.000	2.207 (1.471–3.310)	0.000
The adoption of bisphosphonates
With	36	13
Without	84	6	0.0355	1.533 (1.015–2.315)	0.042	0.904 (0.563–1.451)	0.676
Initial diagnosis because of spinal metastasis or not
No	39	6
Yes	81	9	0.9079	0.977 (0.656–1.455)	0.910
Adoption of adjuvant treatment (including chemotherapy or radiation therapy)
With	65	10
Without	55	7	0.2584	1.237 (0.846–1.806)	0.272

*Number of patients
^ΔMedian overall survival (mo)
^◇Hazard ratio (95% CI)
OS, overall survival; HR, hazard ratio; CI, confidence interval; ESR, erythrocyte sedimentation rate; ALP, alkaline phosphatase; LDH, lactic dehydrogenase

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