This study aimed to develop a nationwide, consensus-based surgical checklist to standardize transurethral resection of bladder tumor procedures and documentation.

Olfactory neuroblastoma (ONB) is a rare malignant tumor of the sinonasal tract. The objective of this study is to present an evidence-based synthesis of the recommendations of the French Expert Network of Rare ENT Cancers (REFCOR), published in 2022, concerning the diagnostic and therapeutic management of ONB.

The NCCN Clinical Practice Guidelines for Breast Cancer include recommendations for clinical management of patients with carcinoma in situ, invasive breast cancer, Paget's disease, Phyllodes tumor, inflammatory breast cancer, and management of breast cancer during pregnancy. The panel convenes annually to update recommendations based on a review of recently published clinical trials. This selection from the NCCN Guidelines for Breast Cancer focuses on the recommendations for the management of recurrent or stage IV (M1) metastatic breast cancer. It summarizes the treatment strategies stratified by tumor biology, including hormone receptor status and HER2 expression, as well as clinical factors such as prior therapy and disease-free interval. Throughout all treatment lines, supportive care, quality of life preservation, toxicity minimization, and clinical trial participation are emphasized as integral components of patient care.

The authors present the guidelines of the REFCOR French expert network for rare head-and-neck cancers for the management of sinonasal squamous cell carcinoma (SNSCC).

Accurate mediastinal nodal staging is essential for the management of non-small cell lung cancer (NSCLC), as it refines prognosis, guides multimodal treatment, and improves survival. This joint consensus document from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Thoracic Surgeons (SECT) updates and expands the 2011 SEPAR guidelines, incorporating the 9th edition of the TNM classification and extending recommendations to the entire perioperative setting, including both preoperative and intraoperative mediastinal staging. The recommendations were developed through a structured review of the literature and multidisciplinary expert consensus. This document synthesizes current evidence on the role of endoscopic and surgical approaches for perioperative invasive staging, including endobronchial and oesophageal ultrasound-guided techniques, mediastinoscopy and its variants, transcervical lymphadenectomies and intraoperative lymphadenectomies. In addition, the consensus integrates the International Association for the Study of Lung Cancer (IASLC) definitions of completeness of resection and proposes quality standards for intraoperative lymphadenectomy. A practical staging algorithm is provided, stratifying tumours according to risk factors of occult mediastinal disease such as tumour size and radiological nodal involvement. The new recommendations emphasise that invasive mediastinal staging is not required for T1a and T1b tumours without radiological evidence of nodal disease, regardless of their location. Conversely, particular attention is given to the role of N1 disease, which is now recognised as a setting associated with a high risk of unsuspected mediastinal involvement. For cases with intermediate suspicion of mediastinal disease, surgical staging techniques demonstrate superior accuracy compared with endosonography alone. Overall, these recommendations aim to harmonize perioperative invasive staging across disciplines, minimize under- and overstaging, and support precise therapeutic decision-making in the evolving era of targeted and immune-based treatments for NSCLC.

Reirradiation can be considered for some patients with recurrent or second primary head and neck squamous cell carcinoma arising within previously irradiated regions, a clinical scenario associated with few therapeutic options. The increasing use of modern conformal radiotherapy techniques, including intensity-modulated radiotherapy, proton therapy, and stereotactic body radiotherapy, has expanded the feasibility of reirradiation in clinical practice. However, evidence remains heterogeneous, and clinical choices are challenged by substantial variability in patient presentation, previous treatments, and toxicity risk. This international expert consensus statement aims to provide pragmatic guidance across key domains, including patient selection, imaging, target delineation, treatment planning, dose accumulation, and toxicity management. Developed through a structured expert consensus process with formal agreement assessment, this document reflects current expert practice. By offering a shared clinical framework, this consensus seeks to promote more consistent practice, facilitate communication across centres, and support future research efforts in this complex and evolving field.

Imaging is central to diagnosing, staging, evaluating treatment response, and guiding post-therapy surveillance in osteosarcoma and Ewing sarcoma, yet no international consensus defines optimal modalities or schedules. This European guideline, developed by 36 multidisciplinary experts, seeks to standardise imaging for research and enhance patient care. A systematic review identified 2026 studies, of which 13 met criteria, revealing marked heterogeneity in diagnoses, chemotherapy regimens, and imaging protocols. Evidence remains inconclusive regarding the optimal modality for detecting bone metastases, and no metabolic imaging indices or MRI parameters consistently predict response or survival. Data are similarly insufficient to define the ideal frequency of post-treatment surveillance. Recommendations for clinical practice were formulated according to International Guideline Harmonization Group standards, based on evidence and expert opinion. In total, 32 consensus-based recommendations were issued. Substantial evidence gaps persist, underscoring the need for international prospective imaging studies to establish robust, harmonised standards for future patient care.

Metastatic breast cancer (mBC) has become a chronic disease for a growing number of women thanks to therapeutic advances, generating a new population of patients with prolonged response. This article, written by experts in oncology and primary care (PC) in Spain, offers practical recommendations for the comprehensive management of these patients. It addresses strategies to improve therapeutic compliance, the detection and management of toxicities, the early identification of signs of progression, and the management of comorbidities and drug interactions. In addition, it emphasizes the importance of psychosocial support, the promotion of healthy habits, and coordination between oncology and PC to optimize quality of life and continuity of care. The effective integration of PC in the follow-up of patients with mBC and prolonged response is key to maintaining therapeutic benefits and the overall well-being of patients.

The aim of this work is to update the practical guidelines for adjuvant radiotherapy of the regional lymphatics in breast cancer, originally issued in 2014 by the Breast Cancer Expert Panel of the German Society of Radiation Oncology.

Accurate mediastinal nodal staging is essential for the management of non-small cell lung cancer (NSCLC), as it refines prognosis, guides multimodal treatment, and improves survival. This joint consensus document from the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) and the Spanish Society of Thoracic Surgeons (SECT) updates and expands the 2011 SEPAR guidelines, incorporating the 9th edition of the TNM classification and extending recommendations to the entire perioperative setting, including both preoperative and intraoperative mediastinal staging. The recommendations were developed through a structured review of the literature and multidisciplinary expert consensus. This document synthesizes current evidence on the role of endoscopic and surgical approaches for perioperative invasive staging, including endobronchial and oesophageal ultrasound-guided techniques, mediastinoscopy and its variants, transcervical lymphadenectomies and intraoperative lymphadenectomies. In addition, the consensus integrates the International Association for the Study of Lung Cancer (IASLC) definitions of completeness of resection and proposes quality standards for intraoperative lymphadenectomy. A practical staging algorithm is provided, stratifying tumours according to risk factors of occult mediastinal disease such as tumour size and radiological nodal involvement. The new recommendations emphasise that invasive mediastinal staging is not required for T1a and T1b tumours without radiological evidence of nodal disease, regardless of their location. Conversely, particular attention is given to the role of N1 disease, which is now recognised as a setting associated with a high risk of unsuspected mediastinal involvement. For cases with intermediate suspicion of mediastinal disease, surgical staging techniques demonstrate superior accuracy compared with endosonography alone. Overall, these recommendations aim to harmonize perioperative invasive staging across disciplines, minimize under- and overstaging, and support precise therapeutic decision-making in the evolving era of targeted and immune-based treatments for NSCLC.

Part 2 of the guideline addresses the updates on treatment recommendations in immunocompetent as well as immunosuppressed patients with invasive cutaneous squamous cell carcinoma (CSCC), based on current literature and expert consensus. A multidisciplinary panel of experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), the European Society for Radiotherapy and Oncology (ESTRO), the European Union of Medical Specialists (UEMS)-Dermatology Venereology and the European Organization of Research and Treatment of Cancer (EORTC), was formed to update the previous guideline on CSCC (version 2023). For common primary CSCC, first-line treatment is surgical excision with post-operative margin assessment or micrographically controlled surgery. Achieving clear histological margins is key for patients with CSCC amenable to surgery. Radiotherapy should be considered for non-surgical candidates/tumors. For patients with macroscopic regional lymph node metastases, individualized treatment should be discussed in the multidisciplinary tumor board. For patients with metastatic or locally advanced CSCC who are not candidates for curative surgery or radiotherapy, anti-PD-1 agents are the first-line systemic treatment, with cemiplimab being the approved systemic agent for advanced CSCC by the EMA. Second-line systemic treatments for advanced CSCC, include clinical trials, EGFR inhibitors (cetuximab) combined with anti-PD-1 immunotherapy, or chemotherapy or radiotherapy. The decision for adjuvant cemiplimab for CSCC at high risk of recurrence after surgery and radiotherapy should be discussed in the multidisciplinary tumor board. In addition, multidisciplinary board decisions are mandatory for all patients with advanced CSCC, considering the risks of toxicity, the age and frailty of patients and co-morbidities, including immunosuppression. Patients should be engaged in informed, shared decision-making on management and be provided with best supportive care to improve symptom management and quality of life. Frequency of follow-up visits and investigations for subsequent new CSCC depend on underlying risk characteristics.

Invasive cutaneous squamous cell carcinoma (CSCC) is one of the most common cancers in white populations, accounting for 20% of all cutaneous malignancies. A collaboration of multidisciplinary experts from the European Association of Dermato-Oncology (EADO), the European Dermatology Forum (EDF), the European Society for Radiotherapy and Oncology (ESTRO), the European Union of Medical Specialists (UEMS)-Dermatology Venereology, and the European Organization of Research and Treatment of Cancer (EORTC), was formed to update guideline recommendations on CSCC (previous version 2023), based on current literature and expert consensus. Part 1 of the guidelines addresses diagnostics and prevention in immunocompetent as well as immunosuppressed patients. CSCC may be classified as easy-to-treat (vast majority) or difficult-to-treat, common primary CSCC, and is further defined as low risk or higher risk depending on the risk of recurrence or metastasis. A new classification of five groups of difficult-to-treat CSCC (DTT-CSCC) is proposed, published in 2025 by EADO experts and reflecting the commonly encountered clinical challenges. Difficult-to-treat (DTT) CSCC includes DTT-common CSCC groups 1 and 2 (which correspond to a subgroup of common CSCC that are complex to treat due to tumor and/or patient characteristics or multiplicity), DTT-CSCC group 3 corresponding to locally advanced CSCC, and DTT-CSCC groups 4 and 5 corresponding to CSCC with locoregional or distant metastases, respectively. The first step of diagnostics is based on clinical and dermatoscopic features, and is always confirmed by histopathology. The presence of risk factors characterizes higher risk CSCC, and the more risk factors, the higher the risk. After the histological diagnosis of CSCC has been established, the second step includes staging procedures, such as physical examination and, when indicated, imaging. In the third and final step, the clinical, histologic and radiologic findings are incorporated into staging systems. The more widely used staging systems are the American Joint Committee on Cancer 8th edition (AJCC8) and the Brigham and Women's Hospital (BWH) systems. Prevention strategies include oral nicotinamide and sun protection measures.

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in theASCO Guidelines Methodology Manual. ASCO Living Guidelines follow theASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only). Updates are published regularly and can be found athttps://ascopubs.org/nsclc-da-living-guideline.

Living guidelines are developed for selected topic areas with rapidly evolving evidence that drives frequent change in recommended clinical practice. Living guidelines are updated on a regular schedule by a standing expert panel that systematically reviews the health literature on a continuous basis, as described in theASCO Guidelines Methodology Manual. ASCO Living Guidelines follow theASCO Conflict of Interest Policy Implementation for Clinical Practice Guidelines. Living Guidelines and updates are not intended to substitute for independent professional judgment of the treating clinician and do not account for individual variation among patients. See appendix for disclaimers and other important information (Appendix 1 and Appendix 2, online only). Updates are published regularly and can be found athttps://ascopubs.org/nsclc-non-da-living-guideline.

Complete mesocolic excision (CME) has been proposed as a refinement of oncological surgery for right-sided colon cancer, aiming to improve specimen quality, lymph node yield and oncological outcomes. However, its routine adoption remains controversial due to uncertainty regarding oncological benefit and concerns relating to technical complexity, training and service delivery. This position statement from the Association of Coloproctology of Great Britain and Ireland (ACPGBI) examines the contemporary evidence surrounding CME and its role within modern management of right-sided colon cancer.

The German Guideline Committee (AGO: Working Group on Gynecologic Cancers) updated its yearly recommendations on the diagnosis and treatment of breast cancer in March 2026. Chapters on oncological and oncoplastic-reconstructive surgery are coordinated with the Working Group for Plastic, Aesthetic, and Reconstructive Surgery in Gynecology (AWOgyn). The most important changes include the ommission of sentinel lymph node biopsy (SLNB) and preffered axillary staging in patients with node-positive breast cancer undergoing neoadjuvant chemotherapy (NACT). Targeted axillary dissection (TAD) is endorsed as the method of choice [AGO ++] in patients converting from cN + to ycN0 status, and other de-escalated techniques (SLNB, target lymph node biopsy [TLNB]) are also possible options [AGO +]. Following NACT, ALND is indicated only when macrometastatic disease is detected in the sentinel and/or in the target lymph node.

In lung cancer, adequate treatment selection relies on accurate diagnosis and staging. Tissue sampling is generally indicated. This guideline explores the role of endosonography via the major airways (endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)) and oesophagus (endoscopic transoesophageal ultrasound-guided fine-needle aspiration (EUS-FNA)). EUS-FNA can also be performed using an EBUS scope (EUS-B-FNA).

The NCCN Guidelines for Bladder Cancer provide strategies for the diagnosis, treatment, and follow-up of patients with bladder cancer, which is the sixth most common cancer in the United States. Bladder cancer can be divided into 3 categories along a clinical spectrum: (1) non-muscle-invasive bladder cancer; (2) muscle-invasive bladder cancer; and (3) metastatic bladder cancer, with most patients falling into the category of non-muscle-invasive disease. Thus, the selected content featured in this issue specifically covers the clinical presentation and workup of and subsequent management recommendations for non-muscle-invasive bladder cancer.

In the time since the last Clinical Practice Committee review of treatment of women with endometrial cancer in 2021, the field of gynecologic oncology has seen significant changes in endometrial cancer from understanding risk factors, addition of molecular staging, and expanded use of maintenance and targeted therapies. Despite these advances, the incidence of endometrial cancer as well as the deaths attributable to the disease continued to rise. Fortunately, since then, there has been progress in the treatment of patients with endometrial cancer, including increased utilization of molecular pathology, greater understanding of genetic predisposition, enhanced methods for lymph node assessment, a broader understanding of the efficacy of radiation and chemotherapy, and a more efficient approach to survivorship and surveillance. The purpose of this document is to present a comprehensive review of this progress. Manuscript development process: The authors reviewed the available evidence, contributed to the development of this manuscript, provided critical review of the guidelines, and finalized the manuscript recommendations. The review was also presented to and approved by the Society of Gynecologic Oncology (SGO) Clinical Practice Committee, Document Review Panel, and the Board of Directors prior to submission for publication. The recommendations for this manuscript were developed by a panel of gynecologic oncologists who were members of the SGO Clinical Practice Committee and subject matter experts. Panelists reviewed and considered evidence from current uterine cancer literature. The terminology used in these guidelines was adopted from the ASCCP management guidelines [1] using a two-part rating system to grade the strength of recommendation and quality of evidence. The rating for each recommendation is given in parentheses.

The NCCN Guidelines for Prostate Cancer include recommendations for staging and risk assessment after a prostate cancer diagnosis and for the care of patients with localized, regional, recurrent, and metastatic disease. These NCCN Guidelines Insights summarize the panel's discussions on select 2026 updates to the guidelines regarding nonmetastatic disease: the elimination of the very-low-risk group, updates to the Principles of Active Surveillance, and caution in the use of focal therapy in newly diagnosed patients.