Table 3 Revised Tokuhashi scoring system^a

1. Preoperative KPS

 Poor (10–40)

0

 Moderate (50–70)

1

 Good (80–100)

2

2. Extent of extraspinal disease

 ≥ 3 lesions

0

 1–2 lesions

1

 No lesions

2

3. Vertebral body metastases

 ≥ 3 lesions

0

 2 lesions

1

 1 lesion

2

4. Status of major internal organ metastases

 Non-removable lesions

0

 Removable lesions

1

 No lesions

2

5. Primary cancer location

 Lung, osteosarcoma, stomach, bladder, esophagus, pancreas

0

 Liver, gallbladder, unidentified

1

 Others

2

 Kidney, uterus

3

 Rectum

4

 Thyroid, breast, carcinoid tumor

5

6. Palsy or myelopathy

 Complete

0

 Incomplete

1

 None

2