Surgical treatment in the Management of Spinal Metastasis: A Single-Center Retrospective Observational Study

Surgical treatment in the Management of Spinal Metastasis: A Single-Center Retrospective Observational Study | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Surgical treatment in the Management of Spinal Metastasis: A Single-Center Retrospective Observational Study Ying Yun Chen, Jiun Lin Yan This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6854599/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Advancements in cancer therapies have significantly prolonged patient survival, resulting in a growing number of individuals living with advanced disease. Consequently, the incidence of spinal metastases has increased, thereby posing a growing clinical challenge of diminished quality of life. This study aimed to evaluate survival outcomes in patients with spinal metastases with or without surgery, and the correlation with Tomita or Tokuhashi scores. This is a retrospective observational study of 188 patients who received radiotherapy for spinal metastases between December 2019 and February 2024 at a single tertiary center. Survival outcomes, including overall survival (OS) and post–bone metastasis survival (PBMS), were analyzed. Correlations between survival and Tomita or Tokuhashi scores and impact of treatment alignment with Tomita score recommendations were evaluated. Among the patients, 29.3% underwent surgical intervention. Patients who received surgery had significantly improved one-year OS (p < 0.001), and a trend toward longer PBMS (median: 14.8 vs. 6.5 months, p = 0.078). Tomita score was inversely correlated with PBMS but not with OS. In contrast, Tokuhashi score did not significantly correlate with either outcome. Treatment plans were consistent with Tomita score recommendations in 28.3% of cases. However, no survival benefit was observed for patients receiving Tomita-aligned strategies. Surgical intervention was associated with improved one-year survival among patients with spinal metastases receiving radiotherapy. The Tomita score demonstrated limited prognostic value and treatment recommendations adherence did not improve survival. These findings highlight the limitations of existing scoring systems and the need for individualized strategies in managing spinal metastases. Spinal metastasis Tomita score Tokuhashi score Full Text Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6854599","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":471526646,"identity":"53082fc0-1509-4836-b29c-ee78ae3e8ee7","order_by":0,"name":"Ying Yun Chen","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYFACHgbGDxUScvwgdkIBkVqYJc5YGEs2gLQYEKmFgbetItHgAIhDjBbzGbnHJCTOSCQYn1+d+OGBAYM8v9gB/FpkbuSlSRRUSOSZ3Xi7WQLoMMOZsxPwa5GQyDED2VJsduPsBpCWBIPbxGjhbZNI3Dzj7OYfpGnZwN+7jUhbeN4lWwMdZixxg3ebRYKBBBF+Yc89ePNDRZ0cf//ZzTd/VNjI80sT0AIELBIQzWCVEgSVgwDzBzDFf4Ao1aNgFIyCUTACAQA+5UGMjv8bMgAAAABJRU5ErkJggg==","orcid":"","institution":"Chang Gung University","correspondingAuthor":true,"prefix":"","firstName":"Ying","middleName":"Yun","lastName":"Chen","suffix":""},{"id":471526647,"identity":"407b4e03-62f2-454d-9a9a-76f3a4466ae1","order_by":1,"name":"Jiun Lin Yan","email":"","orcid":"","institution":"Chang Gung University","correspondingAuthor":false,"prefix":"","firstName":"Jiun","middleName":"Lin","lastName":"Yan","suffix":""}],"badges":[],"createdAt":"2025-06-09 12:53:18","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6854599/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6854599/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":85296167,"identity":"a86b0f49-cdf3-4311-b5c2-99b92065d49d","added_by":"auto","created_at":"2025-06-24 11:02:11","extension":"pdf","order_by":1,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":515943,"visible":true,"origin":"","legend":"","description":"","filename":"Surgicalmanagementofspinemetastasis20250611.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6854599/v1_covered_982a573d-3752-49c7-9bad-1c4498c5d7a6.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Surgical treatment in the Management of Spinal Metastasis: A Single-Center Retrospective Observational Study","fulltext":[],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":false,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":true,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":true,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Spinal metastasis, Tomita score, Tokuhashi score","lastPublishedDoi":"10.21203/rs.3.rs-6854599/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6854599/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eAdvancements in cancer therapies have significantly prolonged patient survival, resulting in a growing number of individuals living with advanced disease. Consequently, the incidence of spinal metastases has increased, thereby posing a growing clinical challenge of diminished quality of life. This study aimed to evaluate survival outcomes in patients with spinal metastases with or without surgery, and the correlation with Tomita or Tokuhashi scores.\u003c/p\u003e \u003cp\u003eThis is a retrospective observational study of 188 patients who received radiotherapy for spinal metastases between December 2019 and February 2024 at a single tertiary center. Survival outcomes, including overall survival (OS) and post\u0026ndash;bone metastasis survival (PBMS), were analyzed. Correlations between survival and Tomita or Tokuhashi scores and impact of treatment alignment with Tomita score recommendations were evaluated.\u003c/p\u003e \u003cp\u003eAmong the patients, 29.3% underwent surgical intervention. Patients who received surgery had significantly improved one-year OS (p\u0026thinsp;\u0026lt;\u0026thinsp;0.001), and a trend toward longer PBMS (median: 14.8 vs. 6.5 months, p\u0026thinsp;=\u0026thinsp;0.078). Tomita score was inversely correlated with PBMS but not with OS. In contrast, Tokuhashi score did not significantly correlate with either outcome. Treatment plans were consistent with Tomita score recommendations in 28.3% of cases. However, no survival benefit was observed for patients receiving Tomita-aligned strategies.\u003c/p\u003e \u003cp\u003eSurgical intervention was associated with improved one-year survival among patients with spinal metastases receiving radiotherapy. The Tomita score demonstrated limited prognostic value and treatment recommendations adherence did not improve survival. 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