The aim of this study is to compare the clinical features and postoperative survival outcomes between patients with spinal metastasis as the initial manifestation of malignancy and those with spinal metastasis occurring after an established diagnosis of malignancy.

The aim of this study is to compare the clinical features and postoperative survival outcomes between patients with spinal metastasis as the initial manifestation of malignancy and those with spinal metastasis occurring after an established diagnosis of malignancy. By analyzing and contrasting these two groups, we seek to identify any distinctive characteristics, prognostic factors, and potential implications for early detection and treatment strategies in patients with malignant spinal metastases.

Inclusion Criteria:

1. Age ≥ 18 years.
2. Pathologically or radiologically confirmed diagnosis of lung cancer with spinal metastasis.
3. Patients with spinal metastasis who underwent surgical intervention.
4. Adequate medical records and follow-up data available.

Exclusion Criteria:

1. Patients with spinal metastasis originating from non-lung primary tumors.
2. Patients who did not receive surgical treatment for spinal metastasis.
3. Incomplete clinical data or lost to follow-up.

The study population will consist of adult patients diagnosed with lung cancer who have developed spinal metastasis. Participants will be selected from individuals treated at Guangdong Provincial People's Hospital. Eligible patients must have a diagnosis of lung cancer with spinal metastasis confirmed by pathological examination or imaging studies, and must have undergone surgical intervention for spinal metastasis.

Individual participant data (IPD) will not be shared because of patient privacy concerns and local data protection regulations. Data may contain sensitive personal information that cannot be sufficiently anonymized to ensure participant confidentiality.