Evidence map›Paper›PMID 42400634›Full record

ArticleEuropean radiology2026

Conservative management of < 3cm anterior mediastinal lesions in lung cancer screening is safe.

Amyn Bhamani, Chuen R Khaw, Ruth Prendecki, Priyam Verghese, Andrew Creamer, Jennifer L Dickson, Carolyn Horst, Helen Hall, Sophie Tisi, Monica Mullin and 11 more

Abstract read
PubMed Publisher
In one paragraph

Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
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

The trial behind it

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

21 authors.

Amyn BhamaniLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.ORCID http://orcid.org/0000-0002-8575-6119
Chuen R KhawLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Ruth PrendeckiLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Priyam VergheseLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Andrew CreamerLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Jennifer L DicksonLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Carolyn HorstLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Helen HallLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Sophie TisiLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Monica MullinLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Tanya PatrickLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
John McCabeLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Anne-Marie HackerCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
Laura FarrellyCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
Esther Arthur-DarkwaCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
Neal NavaniLungs for Living Research Centre, UCL Respiratory, University College London, London, UK.
Anand DevarajNational Heart and Lung Institute, Imperial College, London, UK.
Allan HackshawCancer Research UK and UCL Cancer Trials Centre, University College London, London, UK.
SUMMIT Consortium
Arjun NairUniversity College London Hospitals NHS Foundation Trust, London, UK.
Sam M JanesLungs for Living Research Centre, UCL Respiratory, University College London, London, UK. s.janes@ucl.ac.uk.

Funding

AstraZeneca N/ACancer Research UK CTUQQR-Dec22/100009Cancer Research UK EDDCPGM\100002Cancer Research UK N/ACRUK Lung Cancer Centre of Excellence N/AGarfield Weston Trust N/AGrail N/AHorizon Europe N/ALongfonds BREATH Consortia N/AMedical Research Council MR/T02481X/1Medical Research Council MR/W025051/1MRC UKRMP2 Consortia N/ANIHR N/ARosetrees Trust N/AStand Up To Cancer SU2C-AACR-DT23-17UCLH Biomedical Research Centre N/AUK Research and Innovation N/AUniversity College London Hospitals Charitable Foundation N/AUniversity of British Columbia N/A
6 · The paper itself

Abstract

objectivesTo determine if a pragmatic, conservative approach to managing < 3 cm anterior mediastinal lesions in lung cancer screening (LCS) is safe. MATERIALS AND

methods55- to 77-year-old current or former smokers underwent low-dose computed tomography (LDCT) screening. Anterior mediastinal lesions < 3 cm at baseline were managed conservatively with annual LDCT follow-up for up to 2 years. Lesions ≥ 3 cm at baseline, growing during follow-up (based on visual assessment), or demonstrating concerning radiological characteristics were referred for further assessment. Outcomes for all anterior mediastinal lesions were assessed using follow-up LDCT images, electronic health records and the national cancer registry. Descriptive frequencies were calculated for all reported outcomes.

resultsThe baseline prevalence of anterior mediastinal lesions was 0.7% (n = 91/12,961). Among 54 participants with < 3 cm lesions who underwent annual LDCT follow-up, 74.1% (n = 40/54) completed 2 years of surveillance, while 26.9% (n = 14/54) required further assessment due to interval growth. Four participants with growing lesions were diagnosed with thymoma following surgery, and one required adjuvant radiotherapy for an R1 resection margin. Among all participants with anterior mediastinal lesions, 16 underwent surgical resection, resulting in eight thymoma diagnoses. The benign resection rate was 50%. No thymic or anterior mediastinal malignancies have subsequently been diagnosed among participants with < 3 cm lesions who completed surveillance within the study over a median follow-up of 1997.5 days.

conclusionScreen-detected anterior mediastinal lesions < 3 cm at baseline without concerning radiological characteristics can be managed conservatively with annual LDCT follow-up. Referral for further assessment only in the event of interval growth does not appear to compromise clinical outcomes. KEY POINTS: Question No standardised approach for managing anterior mediastinal lesions identified incidentally through lung cancer screening currently exists. We aimed to determine if utilising a 3 cm baseline diameter referral threshold for screen-detected anterior mediastinal lesions is safe. Findings 74% of < 3 cm anterior mediastinal lesions remained stable over two annual screening rounds and did not require a secondary care referral. Four (out of 14) individuals with growing lesions during follow-up were diagnosed with thymoma, and one required adjuvant radiotherapy for an incomplete resection. Clinical relevance Utilising a 3 cm baseline referral threshold is safe and may improve the efficiency of large-scale, population-based LCS by reducing referrals to secondary care.

Indexed as

Anterior mediastinal lesionsLow-dose computed tomographyLung cancerLung cancer screening

Identifiers

PMID42400634

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.