Letter to the Editor Comment on: The safety of conservative management of asymptomatic congenital pulmonary airway malformations (CPAMs) in children: A systematic review

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We read with great interest the systematic review by Thorburn et al., which provides timely evidence supporting the safety of expectant management in asymptomatic CPAM patients [1]. We commend the authors for their rigorous methodology and valuable contribution to this ongoing debate. While the findings are reassuring, we wish to highlight a critical issue that warrants further discussion: the substantial heterogeneity in follow-up duration and protocols across included studies, and its implications for interpreting long-term safety.

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Article · Mar 2026 · 1 min read

In brief

This letter responds to a systematic review on conservative management of asymptomatic congenital pulmonary airway malformations in children. The authors acknowledge the review's support for expectant management while raising concerns about heterogeneity in follow-up protocols across studies and its impact on long-term safety interpretation.

Expectant management of asymptomatic CPAM in children appears safe based on systematic review evidence.
Significant heterogeneity exists in follow-up duration and protocols across studies evaluating conservative CPAM management.
Standardized long-term follow-up protocols are needed to definitively establish safety of non-operative CPAM management.
Rigorous methodology supports conservative approach, but interpretation requires caution due to variable surveillance practices.

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