Shao Weipeng, Liu Jie, Li Bobo, Guo Xiaokang, Sun Jian, Li Hui, Guo Hongbo
Department of Thoracic Surgical Ward II, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China.
Front Oncol. 2023 Apr 5;13:1053248. doi: 10.3389/fonc.2023.1053248. eCollection 2023.
The incidence of primary lung cancer (LC) in children and adolescence was rare. We analyzed data from a SEER database to better define the incidence, clinical characters, pathology, treatment, and outcomes of rare primary malignant pulmonary tumors in childhood and adolescence.
Patients were chosen from the SEER database (SEER*Stat 8.4.0 software) from 2000 to 2019 and all patients were pathologically diagnosed with primary malignant tumors of the lung and bronchus. Demographic characteristics of patients (age, gender, race, primary site, laterality, location, differentiation grade, operation methods, histology, and history of radiotherapy and chemotherapy), as well as TNM stage and survival time, were collected.
A total of 301 cases of children ≤19 years of age with a primary malignant pulmonary tumor were reported to the SEER database from 2000 to 2019. There were 143 men (47.5%) and 158 women (52.5%). Whites represented majority of patients (79.7%), followed by Black (13.6%) and others (6.7%). As for the primary site, the main site was the lower lobe (33.2%), followed by the upper lobe (26.9%). Most of the patients (80.4%) underwent surgery. Lobectomy (39.9%) is the main operation method. Only 28 (9.3%) patients received radiotherapy and 112 (37.2) patients received chemotherapy. Carcinoid tumor was the most common histology (29.6%), followed by pulmonary blastoma (PB) (22.3%), mucoepidermoid carcinoma (MEC) (12.3%), adenocarcinoma (10.3%), neuroendocrine tumor (NET) (5.7%), squamous cell carcinoma (SCC) (5.3%), atypical carcinoma (2.3%). The mean follow-up time was 100 months. For the entire group of children and adolescents, the 1-year OS was 89.1%, and the 3-year overall survival (OS) was 79.7%. the 5-year OS was 77.9%, the 10-year OS was 75.7%, and the 15-year OS was 73.9%. And 1-year lung cancer specificity survival (LCSS) was 89.8%, and the 3-year LCSS was 80.4%. the 5-year LCSS was 79.4%, the 10-year LCSS was 77.7%, and the 15-year LCSS was 75.9%. The OS of atypical carcinoma, carcinoid tumor, and MEC were in the top three.
Primary LC in children and adolescent were rare and histopathological diverse. Fortunately, children and adolescents with LC had an overall favorable outcome after treatment. Histology, differentiation grade, surgery, TNM stage, and therapeutic modalities have important influence on OS. The further treatment experience of each pathological type would make better evidence-based practice possible.
儿童和青少年原发性肺癌（LC）的发病率很低。我们分析了监测、流行病学和最终结果（SEER）数据库中的数据，以更好地确定儿童和青少年罕见原发性恶性肺肿瘤的发病率、临床特征、病理、治疗及预后。
从2000年至2019年的SEER数据库（SEER*Stat 8.4.0软件）中选取患者，所有患者均经病理诊断为原发性肺和支气管恶性肿瘤。收集患者的人口统计学特征（年龄、性别、种族、原发部位、侧别、位置、分化程度、手术方式、组织学类型以及放疗和化疗史），以及TNM分期和生存时间。
2000年至2019年期间，共有301例19岁及以下的儿童原发性恶性肺肿瘤被报告至SEER数据库。其中男性143例（47.5%），女性158例（52.5%）。白人患者占大多数（79.7%），其次是黑人（13.6%）和其他种族（6.7%）。就原发部位而言，主要部位是下叶（33.2%），其次是上叶（26.9%）。大多数患者（80.4%）接受了手术。肺叶切除术（39.9%）是主要的手术方式。仅28例（9.3%）患者接受了放疗，112例（37.2%）患者接受了化疗。类癌是最常见的组织学类型（29.6%），其次是肺母细胞瘤（PB）（22.3%）、黏液表皮样癌（MEC）（12.3%）、腺癌（10.3%）、神经内分泌肿瘤（NET）（5.7%）、鳞状细胞癌（SCC）（5.3%）、非典型癌（2.3%）。平均随访时间为100个月。对于整个儿童和青少年群体，1年总生存率（OS）为89.1%，3年总生存率为79.7%，5年总生存率为77.9%，10年总生存率为75.7%，15年总生存率为73.9%。1年肺癌特异性生存率（LCSS）为89.8%，3年LCSS为80.4%，5年LCSS为79.4%，10年LCSS为77.7%，15年LCSS为75.9%。非典型癌、类癌和MEC的总生存率位列前三。
儿童和青少年原发性肺癌罕见，组织病理学多样。幸运的是，患肺癌的儿童和青少年经治疗后总体预后良好。组织学类型、分化程度、手术、TNM分期和治疗方式对总生存率有重要影响。每种病理类型的进一步治疗经验将使更好的循证实践成为可能。
