Evidence map›Paper›PMID 42754719›Full record

ArticleJournal of neuro-oncology2026

Characterizing intradural spinal metastasis in the metastatic cascade: clinical course, dissemination timing, and molecular features in 69 patients.

Yuanxuan Xia, Lansaol Yang, Anthony Davidson, Taha Khalilullah, Connor Liu, Shuodan Zhang, Eric Christenson, Nicholas Theodore, Timothy F Witham, Ali Bydon and 4 more

Abstract read
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Article in Journal of neuro-oncology, 2026. 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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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

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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

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

14 authors.

Yuanxuan XiaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA. yxia17@jhmi.edu.
Lansaol YangDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
Anthony DavidsonDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
Taha KhalilullahDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
Connor LiuDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
Shuodan ZhangDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Eric ChristensonDepartment of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Nicholas TheodoreDepartment of Neurosurgery, University of Arizona College of Medicine-Phoenix, Phoenix, AZ, USA.
Timothy F WithamDepartment of Neurosurgery, University of Chicago, Chicago, IL, USA.
Ali BydonDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
Jon D WeingartDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
Chetan BettegowdaDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.
David O KamsonDepartment of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Daniel LubelskiDepartment of Neurosurgery, Johns Hopkins University School of Medicine, 1800 Orleans St., Zayed Tower 6007, Baltimore, MD, 21287, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionMetastatic cancers to the central nervous system (CNS) usually affect the brain, but a small and clinically significant portion also affect the intradural spinal space. Here, we characterize the molecular features of metastatic intradural spinal disease and describe the metastatic chronology and timeline such cancers go through to reach this space.

methodsAll patients with MRI spine findings of intramedullary or leptomeningeal lesions from 2020-2025 at a tertiary academic center were screened. Patients with primary CNS cancer or non-cancer diagnoses were excluded. Demographic information, imaging findings, dates of primary cancer and metastasis detection, and molecular data across disease sites were collected. The primary outcome of interest was overall survival (OS) after primary diagnosis.

results69 patients met inclusion criteria out of 1401 patients screened. The most common primary pathologies were lung (33.3%) and breast (31.9%). 11.6% of patients underwent surgery for intradural disease. The distribution of intradural spine disease on initial detection was 55.1% cervical, 65.2% thoracic, and 76.8% lumbar. The mortality rate was 87.0% within a median follow-up of 42.0 (IQR 20.6-72.9) months after primary cancer diagnosis. The median time to any metastasis was 0.5 (0-6.7), to the brain was 14.9 (0.6-42.7), to the osseous spine was 19.4 (0.7-38.9), and to the intradural spine was 29.5 (14.0-52.6) months. Targetable mutations were noted in 46.4% of primary lesions and such patients trended towards improved OS (51.7 months, 31.2-105.2) compared to patients without (30.1 months, 12.6-58.9, p = 0.072). This difference was driven by patients with such biomarkers qualifying for targeted therapies, which demonstrated improved OS (56.2 vs 31.2 months, p = 0.029).

conclusionTargetable biomarkers are present in nearly 50% of primary lesions for patients who develop spinal intradural disease, and regular molecular characterization and sequencing of this space (e.g. CSF liquid biopsy) could have a clinically meaningful impact on these patients.

Indexed as

Spinal Cord NeoplasmsSpinal NeoplasmsAdultAgedFemaleFollow-Up StudiesHumansMagnetic Resonance ImagingMaleMiddle AgedPrognosisRetrospective StudiesSurvival RateIntradural spineMetastasisMetastatic cascadeMolecular marker

Identifiers

PMID42754719

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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.