Evidence map›Paper›PMID 40282550›Full record

ArticleCancers2025

Histology-Specific Treatment Strategies and Survival Prediction in Lung Cancer Patients with Spinal Metastases: A Nationwide Analysis.

Abdul Karim Ghaith, Xinlan Yang, Taha Khalilullah, Xihang Wang, Melanie Alfonzo Horowitz, Jawad Khalifeh, A Karim Ahmed, Tej Azad, Joshua Weinberg, Abdel-Hameed Al-Mistarehi and 6 more

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In one paragraph

Article in Cancers, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Abdul Karim GhaithDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0002-9600-609X
Xinlan YangDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Taha KhalilullahDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0002-1257-3987
Xihang WangDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0009-0003-1960-9772
Melanie Alfonzo HorowitzDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Jawad KhalifehDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
A Karim AhmedDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Tej AzadDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Joshua WeinbergDepartment of Neurosurgery, School of Medicine, Ohio State University, Columbus, OH 43210, USA.ORCID 0000-0002-3464-5697
Abdel-Hameed Al-MistarehiDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0003-4713-8536
Chase FosterDepartment of Neurosurgery, School of Medicine, George Washington University, Washington, DC 20052, USA.ORCID 0000-0003-2637-2331
Meghana BhimreddyDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0001-7570-4094
Arjun K MentaDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0002-6371-6052
Kristin J RedmondDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
Nicholas TheodoreDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0001-5355-2683
Daniel LubelskiDepartment of Neurosurgery, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.ORCID 0000-0002-9403-9509

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND/

objectivesSpinal metastases are a common and severe complication of lung cancer, particularly in small cell lung cancer (SCLC), and are associated with poor survival. Despite advancements in treatment, optimal management strategies remain unclear, with significant differences between non-small cell lung cancer (NSCLC) and SCLC. This study evaluates treatment patterns, survival outcomes, and prognostic factors in lung cancer patients with spinal metastases, integrating deep learning survival prediction models.

methodsThis retrospective cohort study analyzed the National Cancer Database (NCDB) to identify NSCLC and SCLC patients diagnosed with spinal metastases. Demographics and treatment modalities were analyzed and adjusted for age, sex, and comorbidities. Kaplan-Meier analysis and Cox proportional hazards models assessed overall survival (OS). Five advanced survival prediction models estimated 1-year and 10-year mortality, with feature importance determined via permutation analysis.

resultsAmong 428,919 lung cancer patients, 5.1% developed spinal metastases, with a significantly higher incidence in SCLC (13.6%) than in NSCLC (5.1%). SCLC patients had poorer OS. Radiation therapy alone was the predominant treatment, and stereotactic body radiation therapy (SBRT) predicted better short- and long-term survival compared to other radiation techniques. High-dose radiation (71-150 Gy BED) improved OS in NSCLC, while reirradiation benefited NSCLC but had a limited impact in SCLC. SurvTrace demonstrated the highest predictive accuracy for 1-year and 10-year mortality, identifying age, radiation dose, reirradiation, and race as key prognostic factors.

conclusionsThe management of spinal metastases requires a histology-specific approach. Radiation remains the primary treatment, with SBRT predicting better short- and long-term survival. High-dose radiation and reirradiation should be considered for NSCLC, while the benefits are limited in SCLC. These findings support histology-specific treatment strategies to improve survival of patients with metastatic lung cancer to the spine.

Indexed as

lung cancermortality risk predictionNSCLCradiation therapySCLCspine metastases

Identifiers

PMID40282550
PMCPMC12025767

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LicenceCC BY
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.