Type of publication:

Conference abstract

Author(s):

Barton P.W.J.; *McAdam J.; James T.; Gomez S.; Morley J.; Dalrymple P.; Smith C.; Ivey S.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S873), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Our aim is to look at surgical follow-up protocols in different UK trusts to critically review and see if follow up varies postsurgical patient with lung cancer. Method(s): A literature review around this topic was conducted to establish if there was an evidence based approach. We collected follow up protocols from 10 trusts in the UK and applied 6 questions to each to allow us to compare the results. Responses were collated, compared and interpreted by the authors. Result(s): Our literature review highlighted there is limited evidence to support how lung cancer patients should be followed up post-surgery. Overall, the literature supports CT based imaging although no specific period is supported. From the protocols reviewed there were common themes identified. Post-surgical follow-up was predominantly nurse led, face to face appointments or mixed with virtual were more common. Frequency of follow-up varied between 3 and 8 months, but apart from one site was consistently over 5 years. Similarly, radiology modality predominantly used CT scan either solely or mixed with chest x-rays. Only one site only used chest x-rays to follow up patients Conclusion(s): Both the literature review and critical review of protocols highlight that further research would be beneficial, looking at a wider population of protocols could help encourage a more standardised approach across the UK to ensure optimum care for patients.

DOI: 10.1016/j.jtho.2025.09.1695

Type of publication:

Conference abstract

Author(s):

Barton P.W.J.; King M.; *Wassell E.; *McAdam J.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S872), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Follow up is an important part of patient care post primary lung cancer resection due to the possibility of cancer recurrence or the development of a new primary lung cancer. We aim to explore post operative patient's with a lung cancer understanding of follow-up and how we can implement and support this practice. Method(s): Between 01/08/2023 and 31/08/2023 every curative intent surgical patient was given a questionnaire to complete whilst attending follow-up clinics. This was rolled out over three UK thoracic surgical centers/Diagnostic centers and targeted patients with lung cancer undergoing follow-up post curative primary lung cancer surgery (excluding carcinoids, recurrence). 148/155 questionnaires were returned, collecting information on demographics, smoking status, operation performed, follow-up period post-surgery and patient understanding of follow-up. The responses were collated, compared and interpreted by the authors. Result(s): 148/155 (96%) patients responded. 62% female, 36% male. 80% Ex-smokers, Lobectomy most common operation 64%. 97% of patients' aware follow-up was required, and 72% identified that this would be for 5 years. 68% knew their diagnosis prior to surgery and 58% their final staging, 9% understood TNM. 58% knew their lung cancer nurse specialist (LCNS) and 54% when radiological investigations would be performed. 57% recall being given advice on improving their health and wellbeing, from (LCNS) 30%. 45% recalled a healthcare professional discussing recurrence. 34% knew the potential signs and symptoms of recurrence. Conclusion(s): This study has identified a gap in patients' knowledge and understanding of follow-up: The necessity of followup; TNM stage relevant to individuals; Schedule and frequency of radiological tests; Signs and symptoms suggestive of lung cancer recurrence. The development of a information leaflet patients with lung cancer by LCNS aims to address this need.

DOI: 10.1016/j.jtho.2025.09.1691

Type of publication:

Conference abstract

Author(s):

Carpo B.; *Arunachalam J.; Gunturu K.

Citation:

Journal of Thoracic Oncology. Conference: 2025 World Conference on Lung Cancer. Barcelona Spain. 20(10 Supplement 1) (pp S864), 2025. Date of Publication: 01 Oct 2025.

Abstract:

Introduction: Pulmonary Langerhans cell histiocytosis (PLCH) is a rare, smoking-related neoplastic lung disease arising from clonal proliferation of dendritic cells. Initially considered a reactive disorder, the discovery of recurrent BRAF V600E mutations has led to its reclassification as a neoplasm. PLCH typically presents with nonspecific respiratory symptoms or may be incidentally detected on imaging. Diagnosis is based on high-resolution computed tomography, with histologic confirmation via biopsy. Smoking cessation remains the cornerstone of treatment, although glucocorticoids and BRAF-targeted therapies are used in selected cases. This study aims to characterize the incidence trends and survival outcomes of PLCH using a large population-based dataset in the U.S. Method(s): We performed a retrospective analysis using SEER (Surveillance, Epidemiology, and End Results) Research Plus (17 registries, 2010-2021). Patients with histologically confirmed Langerhans cell histiocytosis (ICD code 9751/ 3) with a primary site in the lung (C34) were included. Demographic and clinical data collected included age at diagnosis, sex, race/ ethnicity, stage at presentation, treatment modality, and county of residence (metropolitan vs. non-metropolitan). Incidence rates (IRs) per 100,000 were calculated using SEER*Stat and age-adjusted to the 2000 U.S. standard population. Kaplan-Meier survival analysis was performed using GraphPad Prism to evaluate overall survival (OS) and cancer-specific survival (CSS). Result(s): A total of 253 patients with PLCH were identified. The cohort was 57% female and 43% male, with 73% White, 15% Black, 6% Hispanic, 3.5% Asian/Pacific Islander, and 1% American Indian/Alaska Native. At diagnosis, 73% had localized disease and 20% presented with metastases. The overall age-adjusted IR was 0.0132 per 100,000, with the highest annual IR observed in 2016 (0.0493), followed by a decline. Females had a 33% higher IR than males (0.01509 vs. 0.01138; p = 0.028). While Black patients had a higher incidence (0.0190) compared to White patients (0.0160), the difference was not statistically significant (p = 0.37). The highest IR was observed in the 55-59 age group (IR = 0.03840), which was significantly higher than in the 40-44 (IR = 0.01419; p = 0.0004) and 35-39 (IR = 0.01261; p = 0.0001) groups, though not significantly different from those aged 45-54. Nonmetropolitan counties had a significantly higher IR (0.02507) compared to metropolitan counties (0.01185; p = 0.0004). The 5- and 10-year OS rates were 84.38% and 60.08%, respectively, while CSS rates were 96.25% and 93.39%. Adults aged >=60 years had a significantly shorter median OS (mOS) of 81 months compared to younger patients (p < 0.0001; HR 4.19, 95% CI 2.20-7.99). Conclusion(s): PLCH is an extremely rare pulmonary neoplasm with excellent cancer-specific survival but modest overall outcomes, likely reflecting comorbidities or delayed diagnosis. Incidence was highest in females, adults aged 55-59, and residents of nonmetropolitan areas, suggesting demographic and geographic disparities. These findings highlight the importance of early diagnosis and smoking cessation. The potential for disease stabilization or regression following smoking cessation differentiates PLCH from other lung neoplasms and underscores the need for timely recognition and intervention. Further investigation is warranted into the molecular framework and development of targeted therapies for this rare disease.

DOI: 10.1016/j.jtho.2025.09.1675