Oncology

Current management of patients with early breast cancer and an abnormal diagnostic axillary ultrasound: The AVOID prospective multicentre cohort study (2026)

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Type of publication:

Journal article

Author(s):

Potter S.; Blyuss O.; Cox K.; Davis E.; Dodwell D.; Evans A.; James J.; Lowes S.; McIntosh S.A.; Shaaban A.; Wallis M.G.; Sharma N.; Altaf S.W.N.; Armstrong L.; *Asprou F.; Babu G.; Baig M.; Bell N.; Bhide I.; Blackwell L.; Boyd C.; Brown A.; Coggles L.; Dadnam F.; Dalgliesh D.; Edwards D.; Elmosselhy A.; Elzuber W.; Gray K.; Griffiths A.; Gunarathne D.; Harmouche C.; Iqbal S.; Karatasiou A.; Khadtare K.; Khushbakht S.; Larney T.; Lee Q.Y.; Liew S.; Marriott C.; McMahon M.; Menezes R.; Millington S.; Oeppen R.; Pervez A.; Poolovadoo Y.; Rabone A.; Rainford S.; Reilly M.; Rigby D.-M.; Roychaudhury R.; Saha P.; Savaridas S.; Shannon J.; Sharma S.; Siddiqui S.; Singh S.; Taper J.; Vidyaprakash N.; Walajahi F.; Wilding L.; Wilkinson L.; Wong M.K.; Young P.

Citation:

SSRN. (no pagination), 2026. Date of Publication: 25 Mar 2026.

Abstract:

Purpose To explore the current management of patients with early breast cancer and an abnormal pretreatment axillary ultrasound scan (USS).Methods Consecutive patients with newly diagnosed early breast cancer and an abnormal axillary USS undergoing pretreatment axillary biopsy were included. Simple demographic data and information regarding the number and cortical thickness of abnormal nodes, biopsy performed and results together with primary management and postoperative pathology were collected prospectively. Results were summarised with descriptive statistics and USS findings and pathological data compared. Results Between February 2024 and September 2025, 1,100 patients from 47 UK breast units were included. The median age was 58 (interquartile range (IQR) 48-69); most presented via the symptomatic pathway (n=828, 75.3%). Almost half (n=526, 48.1%) had one abnormal node on USS. Nodes with a median cortical thickness of 4.8mm (IQR 3.6-7.2mm) were sampled, most frequently with core biopsy (n=980, 89.1%). 1,062 (96.5%) participants had a diagnostic biopsy, two-thirds of which were malignant (n=761, 66.2%). No cortical thickness threshold for malignancy was identified. Most patients with a negative axillary biopsy underwent sentinel lymph node biopsy but the management of patients with biopsy-proven node-positive disease was highly variable. There was poor correlation between the burden of axillary disease on USS and surgical pathology, but an USS finding of 1-2 abnormal nodes was the best criterion for identifying patients with pathological pN1 disease. Conclusions Management of patients with biopsy-proven node-positive breast cancer in the UK is highly variable. Evidence-based multidisciplinary guidelines will be essential to standardise and improve patient care.

DOI: 10.64898/2026.03.06.26347693

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576eP Observational study in UK patients with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer receiving abemaciclib (2026)

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Type of publication:

Conference abstract

Author(s):

Koliou P.; O'Brien C.S.; Levitt N.; Twelves C.J.; *Pettit L.; Nathan M.; Khan S.; Luttropp K.A.; Pastrello D.; Jarvis R.S.; Oikonomidou O.

Citation:

ESMO Open. Conference: ESMO Open Science for Optimal Cancer Care. Berlin Germany. 11(Supplement 4) (no pagination), 2026. Article Number: 107596. Date of Publication: 01 May 2026.

Abstract:

Background: This subgroup analysis of UK patients from a prior multi-national chart review described characteristics and outcomes of those with HR+/HER2- advanced/metastatic breast cancer (ABC) receiving the cyclin-dependent kinase 4/6 inhibitor (CDK4/6i) abemaciclib with an aromatase inhibitor (AI) or fulvestrant as initial endocrine-based therapy (ET), or who had received prior ET.
Method(s): The analysed patient population received abemaciclib 150 mg twice daily plus AI or fulvestrant per licensed indication. Effectiveness outcomes included real-world progression-free survival (rwPFS) and time to chemotherapy (rwTTC), assessed using Kaplan-Meier by treatment line.
Result(s): Median age of the 101 patients was 62 (interquartile range 55-72) years, 78 (77.2%) were post-menopausal. At abemaciclib start, 88.1% had stage IV disease; 5.0% stage III; and 6.9% unknown. The ET partner was fulvestrant in 68.3% and AI in 31.7%. Fifty patients received abemaciclib as first-line (1L) and 34 as second-line (2L) treatment; third-line cases (n=17) are not reported. Median rwPFS was 30.0 and 17.7 months for patients in 1L or 2L, respectively (Table). Of those who received abemaciclib in 1L and 2L, 13 (26.0%) and 15 (44.1%) patients, respectively, required chemotherapy in a subsequent line; rwTTC for 2L was 23.1 months. At 24 months, 27.0% of 1L and 57.0% of 2L patients had started chemotherapy. Based on time-to-discontinuation data (n=101), 54 patients discontinued abemaciclib due to: disease progression (n=16), toxicity (n=27), physician choice (n=6), or unknown/other (n=5). [Formula presented]
Conclusion(s): In these UK patients with HR+/HER2- ABC, abemaciclib with ET showed meaningful real-world clinical benefits that were consistent with findings from clinical trials. The outcomes reinforce that adding abemaciclib to ET can prolong rwTTC and delay disease progression, supporting ongoing clinical utility in UK patients with HR+/HER2- ABC. Editorial acknowledgement: Medical writing support was provided by Laura Wesley, and Sarah Birch (Rx Communications Ltd, Mold, UK), and funded by Eli Lilly. Legal entity responsible for the study: Eli Lilly and Company.

DOI: 10.1016/j.esmoop.2026.107596

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Tjalma Syndrome: A Rare Autoimmune Cause of Multisystem Serositis (2026)

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Type of publication:

Journal article

Author(s):

Kodamanchile, Aaditya; Ekhelikar, Sowmya; AbiMusaAsa'ari, Ahmad Kamal Azri; Aboushehata, Moustafa; *Ahmad, Nawaid.

Citation:

Cureus. 18(3):e105188, 2026 Mar.

Abstract:

Tjalma syndrome is a rare manifestation of systemic lupus erythematosus (SLE) characterized by pleural effusion, ascites, and elevated cancer antigen 125 (CA-125) levels in the absence of ovarian malignancy. We report the case of a woman in her 50s who presented with recurrent pleuritic chest pain, dyspnea, peripheral edema, ascites, and constitutional symptoms. Initial investigations were inconclusive, resulting in repeated admissions and multidisciplinary referrals. Subsequent immunological testing confirmed SLE. Given the constellation of serositis and elevated CA-125, a diagnosis of Tjalma syndrome was established. Treatment with immunosuppressants such as corticosteroids, hydroxychloroquine, and azathioprine resulted in symptomatic improvement. However, the disease course was complicated by constrictive pericarditis requiring pericardiectomy and later inflammatory arthritis requiring escalation of immunosuppression. This case highlights the importance of considering autoimmune etiologies in patients with unexplained multisystem effusions and elevated tumor markers, thereby avoiding misdiagnosis and unnecessary oncological interventions.

DOI: 10.1177/17562848261446551

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Refining prognosis in advanced renal cell carcinoma: international real-world validation of the Meet-URO score in first-line immunotherapy combinations (2026)

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Type of publication:

Journal article

Author(s):

Rebuzzi, Sara Elena; Ghose, Aruni; Rudman, Sarah; Venugopal, Balaji; Young, Kate; Frazer, Ricky Dylan; Ayodele, Olubukola; Stares, Mark; O'Carrigan, Brent; Ali, Waqas; McGrane, John; Jain, Ankit; Fiala, Ondrej; Chauhan, Vishwani; Michael, Agnieszka; Zarkar, Anjali; Kapur, Gaurav; Charnley, Natalie; Afshar, Mehran; Vengalil, Salil; Forde, Caroline; Brown, Janet; Urun, Yuksel; Bianchini, Diletta; Bahl, Amit; *Srihari, Narayanan; Di Costanzo, Fabrizio; Smalley, Benjamin; Parkes, Joanne; Crabb, Simon; Vasudev, Naveen; Poprach, Alexandr; Brown, Nicholas; James, Lijo; Haywood, Sophia; Tapia, Jose; Vijay, Anupama; Parry, Jane; Cheung, Michael; Mahajan, Ishika; Moon, Niall O; Abrol, Ritika; Tkadlecova, Michaela; Soe, Yamin Shwe Yee; Zargham, Anum; Smith, Michelle; Ashley, Sophie; Hardy, Orla; Patel, Grisma; Tun, Kyaw Kyaw; Johnston, Emma; Sarwer, Abdullah; Bolek, Hatice; Shrestha, Roshani; Challapalli, Amarnath; *Meegan, James; Anpalakhan, Shobana; Buono, Francesco; Kolarikova, Eva; Leung, David Ka-Wai; Murianni, Veronica; Catalano, Fabio; Bimbatti, Davide; Buti, Sebastiano; Signori, Alessio; Fornarini, Giuseppe; Rescigno, Pasquale; Teoh, Jeremy Yuen Chun; Banna, Giuseppe Luigi.

Citation:

Oncologist. 31(7), 2026 Jun 06.

Abstract:

BACKGROUND: Effective risk stratification is essential for guiding treatment decisions in patients with metastatic renal cell carcinoma (mRCC). The Meet-URO score is a novel prognostic model that integrates the International Metastatic RCC Database Consortium (IMDC) criteria with neutrophil-to-lymphocyte ratio (NLR) and the presence of bone metastases. Developed in the immunotherapy era, it has demonstrated superior prognostic accuracy compared to the IMDC score across various clinical settings and treatment strategies. Its validation in the context of first-line immune-based combinations has been awaited.

METHODS: External validation of Meet-URO was performed using a large retrospective real-world cohort of mRCC patients treated with first-line immune-based combinations. Secondary analyses included a comparison with the IMDC score for predicting overall survival (OS) and progression-free survival (PFS). Additionally, restricted mean survival time (RMST) was assessed.

RESULTS: A total of 1,418 patients were included in the analysis: 54% received ICI-ICI regimen (nivolumab plus ipilimumab), while 46% received the ICI-TKI combination. At baseline, 52.5% of patients had an NLR >= 3.2, and 32% had bone metastases. After a median follow-up of 26.8 months, the median OS and median PFS were 34.7 and 11.3 months, respectively. Meet-URO demonstrated effective prognostic stratification, identifying patient groups with markedly different outcomes (median OS 11.5-51.4 months; 3-year OS 26-66%; RMST 20.0-42.8 months). Compared to IMDC, Meet-URO showed a significantly better OS (c-index 0.675 vs 0.643; DELTAc = 0.032, P < .001) and PFS (c-index 0.60 vs 0.58; P < .001) prediction performance.

CONCLUSIONS: Meet-URO demonstrated robust prognostic accuracy. Its integration into routine clinical practice and use as a stratification factor in clinical trials may support more personalized treatment strategies and enhance clinical trial design.

DOI: 10.1093/oncolo/oyag203

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Liver Transplantation as a Salvage Therapy Option in Colorectal Liver Metastases: Feasibility, Oncologic Outcomes, and Survival After Failure of Conventional Therapy-A Systematic Review and Meta-Analysis (2026)

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Type of publication:

Systematic review

Author(s):

Soomro, Faiza Hashim; Kazmi, Tehreem Fatima; *Ansar, Mehwish; Gulnaz, Nadia; Arshad, Rabia; Aiste, Gulla.

Citation:

Cancers. 18(8), 2026 Apr 15.

Abstract:

Introduction: Liver transplantation has re-emerged as a potential therapeutic option for patients with unresectable colorectal liver metastases after failure of standard treatments. This systematic review and meta-analysis evaluated survival outcomes, recurrence patterns, and prognostic factors associated with this approach. Materials and Methods: A systematic review was conducted according to PRISMA 2020 guidelines and registered in PROSPERO. Electronic databases were searched for studies published between November 2015 and November 2025, that assessed liver transplantation in the context of unresectable colorectal liver metastases. Random-effect meta-analyses were conducted to estimate the pooled overall survival, disease-free survival and recurrence rates. Heterogeneity was assessed using I2 statistics.
Results: Twenty-three studies involving patients with unresectable liver-only colorectal metastases were included. Pooled overall survival after liver transplantation was 96.6% at 1 year (95% CI 93.9-99.4; I2 = 44.3%), 73.4% at 3 years (95% CI 62.9-83.9; I2 = 95.4%), and 49.4% at 5 years (95% CI 35.4-63.3; I2 = 90.5%). Ten-year overall survival was approximately 27%. The pooled recurrence rate was 63.5% (95% CI 52.5-76.8), and the type of recurrence was mainly extrahepatic, most commonly pulmonary. Disease-free survival was 64.1% (95% CI 47.5-80.7) with substantial heterogeneity (I2 = 95.6%). Biological risk factors, including carcinoembryonic antigen levels, metabolic tumor volume, and composite risk scores, consistently influenced survival outcomes.
Conclusions: In highly selected patients with unresectable colorectal liver metastases, liver transplantation is associated with favorable long-term survival despite frequent recurrence. Outcomes appear to be primarily driven by tumor biology rather than tumor burden, supporting the cautious use within specialized centers under structured selection protocols.

DOI: 10.3390/cancers18081254

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Intranetwork variation in neoadjuvant therapy delivery for borderline resectable and locally advanced pancreatic cancer: a UK multicentre cohort study (2026)

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Type of publication:

Journal article

Author(s):

Labib, P L; Alarabiyat, M; Powell-Brett, S; Hall, L; Rehman, S; Edwards, D; Ma, Y T; Sivakumar, S; Good, J; Candish, C; Nagy, A; Tsalic, M; Hafeez, T; Kunene, V; *Chatterjee, A; Roberts, K J; Chatzizacharias, N.

Citation:

Annals of the Royal College of Surgeons of England. 2026 Apr 09.

Abstract:

INTRODUCTION: Pancreatic cancer (PC) treatment in the UK is coordinated via regional referral networks, but formal neoadjuvant chemotherapy (NAC) pathways for borderline resectable and locally advanced PC (BR/LAPC) are rare. This cohort study assessed intranetwork variation in access to diagnostics, time to treatment and patient outcomes following NAC for BR/LAPC in our network.

METHODS: All patients with BR/LAPC referred from regional network hospitals between 2017 and 2021 were reviewed. Data were collected on time from first diagnostic computed tomography scan to endoscopy, commencement of NAC, NAC regimens administered and patient outcomes.

RESULTS: In the 155 patients who commenced NAC, there were significant differences in median time to biliary drainage and endoscopic ultrasound between referral hospitals. Time from decision to treat to first administration of NAC was long (median 64 days). There were significant differences in the proportion of patients commenced on mFOLFIRINOX (0-100%, p<0.001) and the proportion completing NAC (0-100%, p=0.012). The likelihood of proceeding to surgical resection was similar between centres.

CONCLUSIONS: There is significant intranetwork variation in access to interventional endoscopy and choice of NAC regimen. Centralised tracking of patients receiving NAC, development of locally agreed treatment protocols and an update to national guidelines are needed to standardise NAC pathways for BR/LAPC.

DOI: 10.1308/rcsann.2026.0023

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Exploring Correlations Between Holistic Needs In Lung Cancer Patients: Insights From Dependancy Tool Data (2026)

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Type of publication:

Conference abstract

Author(s):

Rayson V.; *Greenway T.; Kelly M.; Barnett N.; Kelly S.; Dalrymple P.; Ross J.; Middleton E.; Glover S.; Smith B.; Wilson J.; Weir J.; Shepherd P.; Laguardia A.

Citation:

Lung Cancer. Conference: 24th Annual British Thoracic Oncology Group Conference 2026. EICC Edinburgh, Edinburgh United Kingdom. 212(Supplement 1) (no pagination), 2026. Article Number: 109110. Date of Publication: 01 Feb 2026.

Abstract:

Introduction Holistic assessment is central to personalised cancer care, capturing physical, emotional, practical, and family-related concerns. Understanding how these domains interact can inform integrated care planning and resource allocation. This analysis investigates correlations between patient-reported concerns using the Macmillan Holistic Needs Assessment (HNA), and an adapted dependency tool, aiming to identify patterns that influence complexity and support needs. Method A retrospective secondary analysis was conducted using patient-reported HNA data collected from 210 lung cancer patients across the UK, covering all disease stages. Five domains were examined: Physical Symptoms (0-40), Physical Concerns (0-76), Practical Concerns (0-64), Emotional Concerns (0-48), and Family Concerns (0-20). Pearson correlation coefficients were calculated, where 1.00 indicates perfect correlation and 0.00 indicates no correlation. Data interpretation focused on identifying strong, moderate, and weak associations and exploring potential drivers based on patient responses. Outcomes Strongest correlation: Physical Symptoms Physical Concerns (r = 0.75) Emotional Concerns strongly linked to Practical (r = 0.65) and Family Concerns (r = 0.62) Practical Concerns moderately correlated with Physical Symptoms (r = 0.49) and Family Concerns (r = 0.54) Weakest correlation: Physical Symptoms Family Concerns (r = 0.40) Interpretation: Physical burden drives broader physical concerns, while emotional distress is amplified by practical and family-related challenges. Variability suggests influence from coping strategies, socio-economic context, and perceived family impact. Conclusion The Dependency Tool data gathered does demonstrate a correlation between several types of patient concerns. The strongest link identified is between physical symptoms and physical concerns. Despite CNS's subjective identification of a strong link between patients' emotional concerns and their physical concerns, the evidence only demonstrates a moderate correlation. There is stronger evidence that psychosocial distress is closely tied to logistical challenges and perceived family burden. Disclosure No significant relationship.

DOI: 10.1016/j.lungcan.2026.109110

Is Follow Up for Lung Cancer Surgery Evidence Based Within the UK - a Critical Review of Protocols (2025)

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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

Patient's Understanding of Follow-Up Post Curative Primary Lung Cancer Surgery (2025)

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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

Incidence Trends and Survival Outcomes of Pulmonary Langerhans Cell Histiocytosis: A National Cancer Study Using SEER (2025)

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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