Evidence map›Paper›PMID 41214070›Full record

ArticleScientific reports2025

Tumor size and treatment factors as correlates of 10-year mortality in grade III spinal ependymomas: a nationwide analysis.

William ElNemer, Abdul Karim Ghaith, Taha Khalilullah, Lansaol Yang, Khaled Zaitoun, Joseph Dardick, Jawad M Khalife, A Karim Ahmed, Yuanxuan Xia, Tej D Azad and 2 more

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In one paragraph

Article in Scientific reports, 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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0cells of the map it votes in
0citing papers in PubMed
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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

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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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

12 authors.

William ElNemerDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Abdul Karim GhaithDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA. abdulkarimghaith@gmail.com.
Taha KhalilullahDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Lansaol YangDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Khaled ZaitounDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Joseph DardickDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Jawad M KhalifeDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
A Karim AhmedDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Yuanxuan XiaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Tej D AzadDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Nicholas TheodoreDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.
Daniel LubelskiDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 600 N. Wolfe Street/Meyer 5-181, Baltimore, MD, 21287, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Grade III spinal ependymomas are rare central nervous system tumors with poor prognoses and limited treatment guidance. This study aimed to identify predictors of long-term mortality using a national dataset. The National Cancer Database was queried for patients diagnosed with grade III spinal ependymomas from 2004 to 2017. Demographic, clinical, and treatment variables were analyzed with traditional statistics and machine learning models. Model performance was evaluated with C-index and Integrated Brier Score (IBS), and SHAP analysis was used for feature interpretation. A total of 2,011 patients were included. Surgical resection was performed in 83% of cases, with gross total resection in 96% of those. Radiation was given to 33% (mean 41.4 Gy), and chemotherapy to 18%. Ten-year survival was 75%. Long-term survivors were younger (42 vs. 52 years, P < 0.001), had fewer comorbidities (P < 0.001), and were more often privately insured. Mortality was higher among those receiving radiation (56% vs. 24%, P < 0.001) or chemotherapy (37% vs. 12%, P < 0.001). Random Survival Forest was the best-performing model (C-index 0.724; IBS 0.176), identifying tumor size, radiation, chemotherapy, and surgery as key correlates of mortality. Kaplan-Meier analysis showed reduced survival with radiation and chemotherapy, but improved survival with surgery. Stratified analyses revealed diminished surgical benefit in pediatric patients and small tumors. Tumor size emerged as the strongest correlate of mortality. Surgery improves survival, though benefit varies by age and tumor features. Chemotherapy and radiation correlated with higher mortality, underscoring the need for individualized treatment planning and prospective validation.

Indexed as

EpendymomaSpinal Cord NeoplasmsAdolescentAdultAgedChildChild, PreschoolDatabases, FactualFemaleHumansMachine LearningMaleMiddle AgedNeoplasm GradingPrognosisTumor BurdenEpendymomaMachine learningMortalitySpineSurvivalTumor size

Identifiers

PMID41214070
PMCPMC12603031

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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.