ArticleJournal of neuro-oncology2026
Prognostic value of the Evans index in neoplastic meningitis: a real-world cohort study.
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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4 authors.
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Abstract
purposeNeoplastic meningitis (NM) from solid tumors is associated with a grim outcome. The Evans Index (EI) has recently been proposed as a prognostic imaging biomarker in these patients, but external validation is lacking. We aimed to independently validate its prognostic performance in one of the largest real-world cohorts reported to date.
methodsInformation from patients with NM seen from January 2010 to December 2024 at a single center with an imaging study available for review was retrospectively analyzed. Multivariable adjustments were made to measure the association between EI and overall survival (OS).
resultsA total of 345 patients were included; the most prevalent primary tumors were breast (66%), lung (12%), genitourinary (6%), and head and neck (5%). The median OS (MOS) of the whole cohort was 6.9 months (95% CI, 5.5 to 8.3); the MOS for those with EI ≤ 0.3 was 7.36 months, compared with 2.99 months for those with EI > 0.3 (P = .020). After adjusting for age, sex, primary tumor, Karnofsky Performance Score (KPS), symptoms, extracranial disease activity, CSF protein, and CSF lactic dehydrogenase levels, the EI was significantly associated with mortality (EI > 0.3: HR 1.95 [95% CI, 1.09-3.50], P = .024).
conclusionIn this validation study, the baseline EI was associated with prognosis even after adjustment for confounding factors. The EI may have clinical utility in assessing outcomes in patients with NM.
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