Spinal Instability as a Prognostic Factor in Patients With Spinal Metastasis of Castration-resistant Prostate Cancer

Area of Science:

• Oncology
• Radiology
• Orthopedic Oncology

Background:

• Castration-resistant prostate cancer (CRPC) frequently metastasizes to the spine.
• Spinal metastases can lead to instability and impact patient survival.
• Predictive tools are needed to assess prognosis in CRPC patients with spinal involvement.

Purpose of the Study:

• To evaluate the prognostic capability of the Spinal Instability Neoplastic Score (SINS) for survival in patients with CRPC and spinal metastases.
• To determine if spinal stability, as assessed by SINS, is an independent predictor of overall survival.

Main Methods:

• Retrospective analysis of 42 patients with CRPC and spinal metastases.
• Spinal Instability Neoplastic Score (SINS) was calculated for each patient.
• Overall survival was assessed from the time of SINS evaluation.
• Multivariate analysis was used to identify prognostic factors.

Main Results:

• Spinal stability was observed in 32 patients (group S), while 10 (24%) had potentially unstable or unstable spines (group U).
• Median survival was significantly longer in group S (20 months) compared to group U (10 months) (p=0.0221).
• Prostate-specific antigen (PSA) level, visceral metastasis, and spinal instability (SINS) were significant prognostic factors in multivariate analysis.

Conclusions:

• Spinal stability assessed by the SINS is a novel and significant prognostic factor for survival in patients with CRPC spinal metastases.
• SINS can aid in stratifying risk and predicting outcomes for these patients.