Balain et al evaluated patients with metastatic tumors to the spine, The Oswestry Spinal Cord Index (OSRI) can be used to estimate survival in these patients. The authors are from Robert Jones & Agnes Hunt Orthopaedic and District Hospital in Oswestry, UK
Patient selection: metastatic tumor to the spine
Outcome: median survival
Parameters:
(1) primary tumor pathology (PTP)
(2) general condition based on the Karnofsky Performance Status
|
Parameter
|
Finding
|
Points
|
|
primary tumor pathology
|
slow
|
1
|
|
|
moderate
|
2
|
|
|
rapid
|
4
|
|
|
very rapid
|
5
|
|
general condition
|
KPS >= 80% (good)
|
2
|
|
|
KPS from 50 to 70% (moderate)
|
1
|
|
|
KPS from 10 to 40% (poor)
|
0
|
where:
• Slow-growing: breast, thyroid, prostate, myeloma, hemangioma, endothelioma, non-Hodgkins lymphoma
• Moderate-growing: kidney, uterus, tonsil, epipharynx, synovial cell sarcoma, thymoma
• Rapid-growing: stomach, colon, liver, melanoma, teratoma, pancreas, rectum, unknown origin
• Very rapid growing: lung
OSRI=
= (points for primary tumor pathology) + (2 - (points for general condition))
Interpretation:
• minimum score: 1
• maximum score: 7
• The higher the score the worse the survival.
|
OSRI
|
Median Survival (Whitehouse et al)
|
|
1
|
> 1400 days
|
|
2 or 3
|
325 days
|
|
4 or 5
|
262 days
|
|
6
|
160 days
|
|
7
|
58 days
|
