Bauer and Modified Bauer Score (Skeletal Metastases)
The Bauer score (Bauer and Wedin 1995) and modified Bauer score (Leithner and colleagues 2008) estimate survival after surgery for skeletal metastases, both returned from the same inputs.
Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.
Example
- No visceral metastases
- Yes
- A solitary skeletal metastasis
- Yes
- The primary is NOT lung cancer
- Yes
- The primary is breast, kidney, lymphoma or myeloma
- No
- No pathological fracture
- No
Result: 3
The tool opens with these values already filled in. Replace them with your own.
What the result means
- Direction
- A HIGHER score means a BETTER prognosis. Every item scores the FAVORABLE state. Reading it as severity inverts the answer.
- Original 0-1
- Under 6 months; conservative treatment in the derivation cohort.
- Original 2-3
- Over 6 months; palliative surgery.
- Original 4-5
- Over 12 months; excisional surgery.
- Modified
- Drops pathological fracture. Bands become 0-1, 2, and 3-4 across the same three descriptions.
- Disagreement 1
- NO fracture + one other favorable factor: original 2 (palliative) vs modified 1 (conservative). The ORIGINAL is more optimistic.
- Disagreement 2
- Fracture PRESENT + three favorable factors: both 3, but original palliative vs modified EXCISIONAL. The MODIFICATION is more optimistic.
- Neither wins
- Across all 32 combinations those are the ONLY two disagreements, and they run in OPPOSITE directions.
- Histology
- TWO overlapping items are about the primary. Breast scores both, colon one, lung neither - up to HALF the modified scale.
- Why dropped
- Pathological fracture predicted worse survival in the EXTREMITY group only. The versions are tuned to different anatomy.
- Scope
- Group-level survival. The band strategies describe what was DONE in the derivation cohorts, not what should be done.
What you enter
- No visceral metastases.
- A solitary skeletal metastasis.
- The primary is NOT lung cancer.
- The primary is breast, kidney, lymphoma or myeloma.
- No pathological fracture.
Full field descriptions
- No visceral metastases. Scores 1 for the FAVORABLE state.
- A solitary skeletal metastasis. Scores 1 for the FAVORABLE state.
- The primary is NOT lung cancer. Scores 1 for the FAVORABLE state. One of the TWO overlapping primary-tumor items.
- The primary is breast, kidney, lymphoma or myeloma. Scores 1 for the FAVORABLE state. One of the TWO overlapping primary-tumor items.
- No pathological fracture. Scores 1 for the FAVORABLE state. ORIGINAL ONLY - the modification drops this item.
How this is calculated
Bauer HC, Wedin R. Survival after surgery for spinal and extremity metastases. Acta Orthop Scand. 1995;66(2):143-146. Modified in Leithner A, et al. Eur Spine J. 2008;17(11):1488-1495. Read the source ↗
A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.