Bronchial carcinoids are rare in children and the treatment is based on tumor behavior in adults. The purpose of this study was to determine factors and management strategies associated with long-term survival in the pediatric population using a national cohort. Patients aged ≤20 years with bronchial carcinoid tumors were identified in the 2004–2020 National Cancer Database using ICD-O-3 codes. Tumor characteristics and management were compared among typical (TC) and atypical (AC) histological subtypes using Chi-square and Fisher's exact tests. Kaplan–Meier and univariate Cox proportional hazards analyses were used to assess survival. Of 273 patients, 251 (92%) had TCs, and 22(8%) had ACs. The median (IQR) age was 18 (16,19) years. Most patients underwent lobectomy or bilobectomy (67%), followed by sublobar resection (17%), no resection or bronchoscopic excision or ablation (8%), and pneumonectomy (7.7%). Margins were negative in 96%. Lymph node (LN) assessment was performed in 216 patients (84%) with a median (IQR) of 7(3,13) LNs, and 50 (23%) had ≥1 positive LN. There was no difference in age, resection, margin status, LN assessment, or positivity between TC and AC (all p > 00.05). Detection of nodal metastasis did not increase beyond the resection of 1–3 LNs ( = 0.72). Ten-year survival was worse for AC than TC (79% (41, 100) vs 98% (95, 100), HR = 6.9 (95% CI: 1.2–38.3, p = 0.03). Ten-year survival among those with and without LN assessment was 97% (94, 100) vs 91% (81, 100), HR = 4.0, 95% CI: 0.8–19.9, p = 0.09). There were no deaths in those with negative LN while 10-year survival was 89% (72, 100) in those with ≥1 positive LN. Among children with bronchial carcinoids, survival is excellent with TC or negative LN. Atypical histology and positive LN have poor survival and should prompt close monitoring. These risk factors may be missed in the absence of surgical resection and lymph node sampling. III. Retrospective Study.

中文翻译：

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与支气管和肺类癌儿童长期生存相关的因素

支气管类癌在儿童中很少见，治疗基于成人的肿瘤行为。本研究的目的是通过全国队列确定与儿科人群长期生存相关的因素和管理策略。使用 ICD-O-3 代码在 2004-2020 年国家癌症数据库中识别年龄≤20 岁的支气管类癌患者。使用卡方和 Fisher 精确检验比较典型 (TC) 和非典型 (AC) 组织学亚型的肿瘤特征和治疗。 Kaplan-Meier 和单变量 Cox 比例风险分析用于评估生存率。在 273 名患者中，251 名 (92%) 患有 TC，22 名 (8%) 患有 AC。中位年龄 (IQR) 为 18 (16,19) 岁。大多数患者接受了肺叶切除术或双肺叶切除术（67%），其次是亚肺叶切除术（17%）、不切除或支气管镜切除或消融术（8%）和全肺切除术（7.7%）。 96% 的利润率为负。对 216 名患者 (84%) 进行了淋巴结 (LN) 评估，中位 (IQR) 为 7(3,13) 个 LN，其中 50 名 (23%) 患者的 LN ≥1 个阳性。 TC 和 AC 之间的年龄、切除情况、切缘状态、LN 评估或阳性率没有差异（全部 p > 00.05）。切除 1-3 个淋巴结后，淋巴结转移的检出率并未增加 (= 0.72)。 AC 的十年生存率比 TC 差（79% (41, 100) vs 98% (95, 100)，HR = 6.9 (95% CI: 1.2–38.3，p = 0.03)。其中的 10 年生存率有或没有 LN 评估的比率分别为 97% (94, 100) vs 91% (81, 100)，HR = 4.0，95% CI：0.8–19.9，p = 0.09）。 LN 阴性患者中没有死亡，而 LN ≥1 个阳性患者的 10 年生存率为 89% (72, 100)。在患有支气管类癌的儿童中，TC 或阴性 LN 的生存率很高。组织学不典型和 LN 阳性的患者生存率较差，应进行密切监测。如果没有手术切除和淋巴结取样，这些危险因素可能会被忽视。三．回顾性研究。