ArticleCancers2025
Role of Denosumab in Patients with Intermediate Spinal Instability Neoplastic Score (SINS).
Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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6 authors.
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Abstract
objectivesThe current study aimed to evaluate the effect of denosumab on patients with impending instability due to spinal metastasis, including whether it can improve spinal instability neoplastic score (SINS) and reduce the need for surgical treatment.
methodsThis study retrospectively reviewed patients initially treated non-operatively for metastatic spinal lesions with intermediate SINS (7-12 points) between January 2017 and December 2023 in a single tertiary cancer hospital. Patients were divided into two groups based on the use of denosumab for the intermediate SINS lesion: D-group and N-group. Propensity score matching (PSM) was conducted with a caliper width of 0.025 for the covariates (age, sex, and primary cancer). The study outcomes were (1) the rate of conversion to surgery, (2) the change in SINS, and (3) the change in HU (Hounsfield unit) during the follow-up period.
resultsA total of 286 patients (male 151, female 135) with a mean age of 68.0 ± 12.6 years and a mean follow-up period of 37.1 ± 26.5 months were included. Forty-one (14.3%) patients received denosumab (D-group), whereas 245 (85.7%) did not receive denosumab (N-group). Before PSM, 9.8% (4/41) in the D-group and 18.8% (46/245) in the N-group underwent surgical treatment. The rate of conversion to surgery was similar after PSM: the D-group, 8.3% (3/36) vs. the N-group, 16.6% (6/36). Survival analysis using Kaplan-Meier curves also showed that the D-group had a significantly lower probability of conversion to surgery before and after PSM (
conclusionsIn this study, denosumab lowered the rate of conversion to surgery in patients with impending instability (intermediate SINS) due to spinal metastasis. Patients who received denosumab treatment showed significant improvements in the SINS and HU for their metastatic spinal lesions.
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