title: Primary malignant pulmonary tumors in children: a review of the national cancer data base.
abstract: BACKGROUND
  The purpose is to delineate the clinical and pathological characteristics of rare primary malignant pulmonary tumors in children.
  
  
  METHODS
  Utilizing the National Cancer Data Base (NCDB), we analyzed all children (≤ 18 years) with a primary malignant pulmonary tumor from 1998 to 2011 to identify factors associated with better survival.
  
  
  RESULTS
  Of 211 children identified, the most common histology was carcinoid tumor (n=133, 63%) followed by mucoepidermoid carcinoma (MEC) (n=37, 18%), squamous cell carcinoma (SCC) (n=19, 9%), adenocarcinoma (n=16, 8%), bronchoalveolar carcinoma (BAC) (n=4, 2%), and small cell carcinoma (SCLC) (n=2, <1%). Factors that significantly affected survival include histology, race, tumor size, lymph node status, and extent of surgery. Patients with MEC and carcinoid tumors had a better overall survival compared to patients with other histologies (p<0.0001). The 5-year overall survival for MEC and carcinoid tumors was 100% and 95% (95% CI 87-98), respectively, versus 50% (95%CI 1-91) for BAC, 28% (95%CI 9-52) for SCC, and 26% (95%CI 5-55) for adenocarcinoma.
  
  
  CONCLUSIONS
  The majority of pediatric patients with a primary malignant pulmonary tumor present with carcinoid tumor or MEC and have an excellent prognosis. Lung cancers which are common in adults, but rare in children, have a worse prognosis.
authors: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX.
authors: Yesenia
authors: Y
authors: Rojas
authors: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX.
authors: Yan X
authors: YX
authors: Shi
authors: Outcomes and Impact Service, Department of Surgery, Texas Children's Hospital, Houston, TX.
authors: Wei
authors: W
authors: Zhang
authors: Department of Surgery, University of Alabama, Birmingham, AL.
authors: Elizabeth A
authors: EA
authors: Beierle
authors: Department of Surgery, Methodist Children's Hospital of South Texas, University of Texas Health Science Center - San Antonio, San Antonio, TX.
authors: John J
authors: JJ
authors: Doski
authors: Department of Surgery, John Wayne Cancer Institute/Providence St. Johns Medical Center, Santa Monica, CA.
authors: Melanie
authors: M
authors: Goldfarb
authors: Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA.
authors: Adam B
authors: AB
authors: Goldin
authors: Department of Surgery, Seattle Children's Hospital, University of Washington, Seattle, WA.
authors: Kenneth W
authors: KW
authors: Gow
authors: Department of Surgery, Maine Children's Cancer Program, Tufts University, Portland, ME.
authors: Monica
authors: M
authors: Langer
authors: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX.
authors: Sanjeev A
authors: SA
authors: Vasudevan
authors: Michael E. DeBakey Department of Surgery, Baylor College of Medicine, and Department of Surgery, Texas Children's Hospital, Houston, TX. Electronic address: nuchtern@bcm.edu.
authors: Jed G
authors: JG
authors: Nuchtern
mesh_terms: D000293:Adolescent; D002277:Carcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D016208:Databases, Factual; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology
keywords: National Cancer Database (NCDB); Pediatric; Population-based study; Primary lung cancer