title: Malignant tumors of the parotid gland in children: incidence and outcomes.
abstract: BACKGROUND
  Population-based analysis of the incidence, demographics, and management outcomes in children with malignant tumors of the parotid gland.
  
  
  METHODS
  Surveillance, Epidemiology, and End Results database (1973-2009) was researched for all patients younger than 20 years.
  
  
  RESULTS
  Overall, 284 patients were identified. Annual incidence of these tumors was 1.43 cases per million. The highest incidence occurred in girls (0.86/1,000,000), black children (0.849/1,000,000), and adolescents (1.56/1,000,000). Median age at diagnosis was 13.5 years. Most patients were 10 years or older (n = 256, 90%). Most patients presented with local disease (n = 207, 76%). Only 3% had metastasis at time of diagnosis. Most tumors were mucoepidermoid carcinomas (n = 139, 49%) or acinar cell carcinomas (n = 113, 40%). There were no differences in survival between mucoepidermoid and acinar cell carcinomas (96% vs 98% respectively, P = 0.317). Overall mortality was 4.6% over the study period. Overall survival was 96% at 5 years, 95% at 10 years, and 83% at 20 years. Adolescents had significantly higher mortality rates (7.1% vs 1.6% for children <15 years of age, P = 0.23). Multivariate analysis identified the use of adjuvant radiation therapy (hazard ratio, 6.01; 95% confidence interval, 1.15-31.45; P = 0.034) as the only independent predictor of poor outcome.
  
  
  CONCLUSIONS
  Malignant parotid gland tumors are most common in adolescents, and this subgroup has worse outcomes. The role of radiotherapy remains controversial.
authors.affiliation: From the * Division of General Surgery, DeWitt-Daughtry Family Department of Surgery; †Division of Plastic and Reconstructive Surgery, Leonard Miller School of Medicine, University of Miami; and ‡Division of Pediatric Otorhinolaryngology, Leonard Miller School of Medicine, University of Miami, Miami, FL.
authors.forename: Bassan J
authors.initials: BJ
authors.lastname: Allan
authors.forename: Jun
authors.initials: J
authors.lastname: Tashiro
authors.forename: Sofia
authors.initials: S
authors.lastname: Diaz
authors.forename: Jason
authors.initials: J
authors.lastname: Edens
authors.forename: Ramzi
authors.initials: R
authors.lastname: Younis
authors.forename: Seth R
authors.initials: SR
authors.lastname: Thaller
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D018267:Carcinoma, Acinar Cell / Q000453:epidemiology* / Q000473:pathology; D018277:Carcinoma, Mucoepidermoid / Q000453:epidemiology* / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D015999:Multivariate Analysis; D010307:Parotid Neoplasms / Q000453:epidemiology* / Q000473:pathology; D017678:Sex Distribution; D016019:Survival Analysis