{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,7]],"date-time":"2026-09-07T17:13:18Z","timestamp":1788801198149,"version":"build-2803163510"},"reference-count":47,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:00:00Z","timestamp":1777507200000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82070202"],"award-info":[{"award-number":["82070202"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100001809","name":"the National Natural Science Foundation of China","doi-asserted-by":"crossref","award":["82141119"],"award-info":[{"award-number":["82141119"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"crossref"}]},{"name":"the Beijing Natural Science Foundation","award":["7232058"],"award-info":[{"award-number":["7232058"]}]},{"name":"the Beijing Natural Science Foundation","award":["7242053"],"award-info":[{"award-number":["7242053"]}]},{"name":"the Capital\u2019s Funds for Health Improvement and Research","award":["2022-2-1141"],"award-info":[{"award-number":["2022-2-1141"]}]},{"name":"Reform and Development of Beijing Municipal Health Commission"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Langerhans cell histiocytosis (LCH) is a rare inflammatory neoplasm most commonly involving bone. However, data on single-system, single-site LCH (SS-s-LCH), particularly with unifocal bone disease, remain limited. Management strategies for unifocal osseous LCH vary globally, and the safety of a watchful-waiting approach is not well-defined. This study aimed to evaluate whether patients with osseous SS-s-LCH can be managed with observation alone without compromising long-term outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective, multicenter study, we enrolled children with biopsy-proven osseous SS-s-LCH from 7 centers in the Chinese Children\u2019s Histiocytosis Group, excluding those with central nervous system (CNS)-risk bone lesions. The primary endpoint was 3-year event-free survival (EFS). Events were defined as disease progression or relapse.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort included 134 patients with a median follow-up of 36.0\u2009months. Involved sites were cranial bones (n\u2009=\u200937), vertebrae (n\u2009=\u200933), and other bones (n\u2009=\u200964). At final follow-up, 16 patients experienced an event, yielding a 3-year EFS of 88.1% (95% CI: 81.5%-92.5%). Events included new lesions (n\u2009=\u200914) and primary lesion expansion (n\u2009=\u20092), with 93.8% (15\/16) occurring within the first 12\u2009months after diagnosis. EFS did not differ significantly by involved site or mutation status. However, patients staged by PET-CT at diagnosis had a significantly higher 3-year EFS (97.6%) than those staged by conventional imaging (83.7%) (P\u2009&amp;lt;\u2009.05). Long-term quality of life was satisfactory in all assessed patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Watchful waiting is a safe and effective management strategy for children with unifocal osseous SS-s-LCH. Initial staging with PET-CT may be associated with superior EFS, highlighting its potential value in refining risk assessment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/oncolo\/oyag122","type":"journal-article","created":{"date-parts":[[2026,4,17]],"date-time":"2026-04-17T12:51:47Z","timestamp":1776430307000},"source":"Crossref","is-referenced-by-count":1,"title":["Watchful waiting in children with unifocal osseous Langerhans cell histiocytosis"],"prefix":"10.1093","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-4421-4444","authenticated-orcid":false,"given":"Chenxin","family":"Zhou","sequence":"first","affiliation":[{"name":"Beijing Children\u2019s Hospital, Capital Medical University, National Center for Children\u2019s Health , Beijing 100045,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haixia","family":"Yang","sequence":"additional","affiliation":[{"name":"The Affiliated Children\u2019s Hospital of Xiangya 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