Translational pediatrics最新文献

{"title":"Successful treatment of a 4-year-old girl with pure malignant rhabdoid tumor of the bladder: a case report.","authors":"Jian Li, Jiajia Bao, Tianjiao Hu, Qian Zhao, Jianfeng Zhou, Li Zhou, Tao Li","doi":"10.21037/tp-24-255","DOIUrl":"https://doi.org/10.21037/tp-24-255","url":null,"abstract":"<p><strong>Background: </strong>Extracranial malignant rhabdoid tumors (eMRTs) are rare, highly aggressive neoplasms, predominantly arising in the kidneys, with bladder involvement being extremely uncommon. Optimal management strategies, particularly bladder-preserving approaches, are not well-established due to the rarity of these cases.</p><p><strong>Case description: </strong>We report the case of a 4-year-old girl who presented with persistent gross hematuria. Imaging revealed a large bladder mass and histopathological examination confirmed the diagnosis of an extrarenal rhabdoid tumor with loss of <i>SMARCB1</i> expression. The patient underwent a multimodal treatment approach, including bladder-preserving surgery, 12 cycles of high-dose MRTK-2020 neoadjuvant chemotherapy [comprising actinomycin D, vincristine, doxorubicin, cyclophosphamide (AVDC), ifosfamide, carboplatin, and etoposide (ICE)], followed by adjuvant radiotherapy. Remarkably, the patient achieved complete remission after two cycles of chemotherapy and remained in continuous remission with no evidence of disease at the 15-month follow-up.</p><p><strong>Conclusions: </strong>This case underscores the diagnostic challenges of malignant rhabdoid tumors (MRTs) in bladder pathologies and highlights the significance of considering such tumors in differential diagnoses. Despite the limited evidence base, bladder-preserving surgeries, when feasible, should be considered and accompanied by adjuvant therapies for optimal outcomes. This case illustrates the potential for successful treatment of pure MRTs of the bladder using a combination of surgery, chemotherapy, and radiotherapy.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1879-1884"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of core biopsies for diagnosing inflammatory myofibroblastic tumors in pediatric patients: case series from a single tertiary referral center.","authors":"Ugo Maria Pierucci, Irene Paraboschi, Carlotta Ardenghi, Camilla Viglio, Giorgio Giuseppe Orlando Selvaggio, Giulia Lanfranchi, Michela Casanova, Paola Collini, Marta Barisella, Marcello Napolitano, Anna Camporesi, Gloria Pelizzo","doi":"10.21037/tp-24-239","DOIUrl":"https://doi.org/10.21037/tp-24-239","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory myofibroblastic tumors (IMTs) are rare, often non-metastasizing neoplasms characterized by fibro/myofibroblastic spindle cells with varying infiltrates of plasma cells, lymphocytes, and/or eosinophils. Despite their generally indolent nature, IMTs can exhibit locally aggressive behavior and a significant tendency for local recurrence, making complete surgical resection the standard treatment approach. Accurate diagnosis can be challenging due to the overlap in imaging features with more aggressive tumors, necessitating preoperative biopsies to enable differential diagnosis and guide treatment decisions. The complexity of distinguishing IMTs from other malignancies underscores the importance of biopsy in establishing an accurate diagnosis and planning appropriate management strategies.</p><p><strong>Case description: </strong>This study presents the cases of four pediatric patients (three males, one female) diagnosed with IMT, involving tumors located in the lung (one case), bladder (one case), and liver (two cases). Initial minimally invasive biopsies, including a US-guided tru-cut core biopsy and a percutaneous core biopsy in one case, as well as endoscopic core biopsies in two other cases, yielded inconclusive results. These initial procedures failed to provide definitive diagnostic information, necessitating the use of more precise diagnostic techniques to achieve a definitive histological diagnosis of IMT.</p><p><strong>Conclusions: </strong>The findings indicate that when initial biopsy results are inconclusive in cases suspected to be IMT, more precise diagnostic procedures may be necessary to secure a definitive diagnosis. This highlights the need for careful consideration of alternative biopsy methods to ensure accurate identification and effective management of IMT in pediatric patients.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1799-1809"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628008","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The indications and safety of rituximab for the treatment of pediatric autoimmune diseases: a single-center retrospective study.","authors":"Mohammed A Alsubaie, Abdulrahman B Bahkali, Saeed A Alhudaifi, Majed T Osaylan, Abdulaziz M Alghamdi, Mohammed Nashawi, Faris A Althubaiti","doi":"10.21037/tp-24-233","DOIUrl":"https://doi.org/10.21037/tp-24-233","url":null,"abstract":"<p><strong>Background: </strong>Autoimmune diseases in children pose therapeutic challenges due to their refractory nature and the associated morbidity. Rituximab (RTX), a monoclonal antibody targeting CD20, has emerged as a promising steroid-sparing therapy for various autoimmune disorders by depleting B cells. However, its indications and safety in pediatric populations in our region remain insufficiently studied. This study aims to review the indications and safety of RTX in treating pediatric autoimmune diseases within a single-center setting.</p><p><strong>Methods: </strong>A retrospective study was conducted on pediatric patients aged 18 years or younger who received RTX for different autoimmune diseases between January 2013 and March 2023 at King Abdulaziz University Hospital, Saudi Arabia. Data on demographics, indications, infusion details, adverse events, and concurrent medications were collected and analyzed.</p><p><strong>Results: </strong>Twenty-two patients were included, with nephrotic syndrome and systemic lupus erythematosus (SLE) being the most common indications for RTX. The mean age at diagnosis and first RTX infusion was 8 and 9 years, respectively. The most commonly used protocol involved administering 2 infusions of 375 mg/m² each, given 2 weeks apart. RTX was commonly used as a second-line treatment following corticosteroids. Infusion-related adverse events occurred in 31.8% of patients, ranging from mild reactions such as chest tightness, fever, and headache to severe reactions such as anaphylaxis. No infectious related adverse events were observed.</p><p><strong>Conclusions: </strong>This study highlights both the varied indications for which RTX was prescribed and the need for vigilance concerning infusion-related adverse events. It underscores the importance of close monitoring and appropriate management to ensure the safety of RTX therapy in pediatric patients. Further research is warranted to optimize treatment strategies and enhance patient outcomes in this population.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1696-1702"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543116/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvements in Children's Oncology Group neuroblastoma risk stratification through a change in age cut-off and use of INRGSS.","authors":"Wendy B London, Hannah Bousquet, Meredith S Irwin, Michael D Hogarty, Susan L Cohn","doi":"10.21037/tp-24-319","DOIUrl":"10.21037/tp-24-319","url":null,"abstract":"","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1899-1901"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Significance of binocular fusion in enhancing visual acuity during amblyopia treatment.","authors":"Zongyue Lv, Zhengyang Tao, Guorui Hu, Hongwei Deng","doi":"10.21037/tp-24-125","DOIUrl":"https://doi.org/10.21037/tp-24-125","url":null,"abstract":"<p><strong>Background: </strong>Currently, the exploration of amblyopia treatment methods is gradually shifting to the restoration of binocular visual perceptual function. Binocular fusion function, as an important component of binocular visual function, mainly reflects the patient's ability to integrate the signals received from both eyes. In this study, we investigated the relationship between binocular fusion function and improvement in visual acuity during amblyopia treatment.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on a cohort of patients with amblyopia, aged 3-14 years old, who visited an outpatient clinic in Shenzhen Eye Hospital between May 2021 and January 2023. The investigation included 105 patients (210 eyes) with isometropic or anisometropic amblyopia. All participants underwent cycloplegic refraction examination and binocular fusion function measurement. All patients underwent standard amblyopia treatment, and those with the best-corrected visual acuity (BCVA) of 0.6 or higher in the amblyopic eye of both eyes received binocular fusion training using a computer platform.</p><p><strong>Results: </strong>A statistically significant negative correlation (-0.263, P=0.007) was observed between the absolute difference in binocular BCVA and binocular fusion function at the start of treatment (baseline). Linear regression analysis revealed that the improvement in BCVA in the amblyopic eye exhibited correlations with several factors, including the baseline binocular BCVA difference, baseline BCVA of the amblyopic eye, improvement in binocular fusion function, and the number of fusion training sessions (regression coefficients: -0.463, -0.771, 0.007, and 0.063, respectively; all P<0.05). Two patterns of binocular fusion function development during treatment were identified using group-based trajectory modeling (GBTM): the slow growth pattern and the rapid growth pattern. The results of a multivariate logistic regression model indicated a statistically significant link between fusion training and the development pattern of binocular fusion function [odds ratio (OR): 5.219, 95% confidence interval (CI): 2.045-13.323].</p><p><strong>Conclusions: </strong>Enhancing binocular fusion function may result in an improvement of BCVA in the amblyopic eye of patients with amblyopia. The frequency of binocular fusion training is crucial for rapid improvement in binocular fusion function.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1767-1776"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543132/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of teamwork and mentorship in pediatric and congenital heart surgery.","authors":"Jeevan Francis, Joseph George, Edward Peng, Antonio F Corno","doi":"10.21037/tp-24-285","DOIUrl":"https://doi.org/10.21037/tp-24-285","url":null,"abstract":"<p><p>Pediatric and congenital cardiac surgery, characterized by its complexity and high-stakes nature, demands superior technical expertise and multidisciplinary teamwork. With limited surgeons worldwide, the role of continuous skill refinement and collaborative practice is crucial for patient safety and successful outcomes. A literature search was performed using the PubMed, Cochrane, SCOPUS and Web of Science databases for studies published until September 2024. Articles were analysed to summarize findings on the impact of mentorship and teamwork within pediatric and congenital cardiac surgery. This article explores the dual importance of teamwork and mentorship in shaping the next generation of pediatric and congenital cardiac surgeons. The study examines the impact of mentorship on reducing learning curves and improving surgical outcomes whilst highlight the unique challenges faced by surgeons in low-income countries (LICs). Effective mentorship can serve as a bridge between knowledge and practice, ensuring that surgeons in resource-constrained environments can confidently adapt to challenges and improve patient outcomes despite the limited resources. By emphasizing a culture of innovation and collaborative teamwork, pediatric and congenital cardiac surgery continues to achieve increasingly better patient outcomes on a global scale. This study highlights how continuous mentorship and teamwork not only enhance technical proficiency but also drive advancements in surgical techniques and overall care, contributing to the ongoing global progress in pediatric and congenital cardiac surgery.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1870-1878"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Origin and factors for overgrowth in pediatric fractures of the femoral shaft after flexible intramedullary nail fixation.","authors":"Haodong Li, Junming Liu, Dahui Wang, Dong Fu","doi":"10.21037/tp-24-171","DOIUrl":"https://doi.org/10.21037/tp-24-171","url":null,"abstract":"<p><strong>Background: </strong>Leg length discrepancy is a common complication following flexible intramedullary nail (FIN) fixation for femoral shaft fractures in adolescents. This retrospective study was designed to evaluate the possible cause of femoral overlengthening in children with femoral shaft fracture.</p><p><strong>Methods: </strong>We retrospectively included 138 patients diagnosed with femoral shaft fractures between June 2012 and December 2022 and reported the clinical/radiological outcomes after at least half a year of surgery. We have introduced a new parameter, distal physis growth proportion (DPGP), which can be used to predict the origin of femoral growth.</p><p><strong>Results: </strong>The mean DPGP value of 138 samples was 50.9%, of which 24 (17.4%) were greater than 70% and 114 (82.6%) were less than 70%. In the group with nail-canal diameter ratio (NCD) values greater than 60%, the proportion of patients with DPGP values exceeding 70% was significantly higher compared to the group with NCD values less than 60%. However, there was no significant difference between gender, fracture side, fracture type, mode of reduction, associated craniocerebral injury or the distance from fracture site to distal articular surface of femur.</p><p><strong>Conclusions: </strong>In children with femoral shaft fractures treated with FIN fixation, the number of patients with DPGP lesser than 70% far exceeded the number of patients with DPGP greater than 70%, indicating the significant role of fracture end stimulation in femoral lengthening.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1711-1719"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543119/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quercetin inhibits ferroptosis through the SIRT1/Nrf2/HO-1 signaling pathway and alleviates asthma disease.","authors":"Bo Sun, Fei Cai, Liming Yu, Ran An, Bing Wei, Miao Li","doi":"10.21037/tp-24-193","DOIUrl":"https://doi.org/10.21037/tp-24-193","url":null,"abstract":"<p><strong>Background: </strong>Quercetin (QCT) is a bioflavonoid derived from vegetables and fruits that has anti-inflammatory and anti-ferroptosis effects against various diseases. Previous studies have shown that QCT modulates the production of cellular inflammatory factors in asthma models and delays the development of chronic airway inflammation. However, the regulatory mechanism of QCT, a traditional Chinese medicine, in the treatment of asthma has not been elucidated. The aim of the present study is to investigate whether QCT can inhibit ferroptosis via the SIRT1/Nrf2 pathway and play a therapeutic role in asthma.</p><p><strong>Methods: </strong>An ovalbumin-induced mouse asthma model was established, and its function was verified by hematoxylin eosin staining, enzyme linked immunosorbent assay, ferric ion assay, malondialdehyde and superoxide dismutase assays, dihydroethidium staining, immunohistochemical staining, western blotting, and quantitative real-time polymerase chain reaction.</p><p><strong>Results: </strong>Our results indicated that an ovalbumin-induced asthma mouse model had been successfully established and that QCT inhibited inflammation, reduced serum levels of inflammatory factors IL-4, IL-5 and IL-13, increased superoxide dismutase levels in lung tissue homogenates, and reduced malondialdehyde and ferric ion production in asthmatic mice. In addition, we found that QCT was able to reverse the expression of SIRT1, Nrf2 and HO-1 in an <i>in vivo</i> asthma mouse model.</p><p><strong>Conclusions: </strong>The data from this study indicate that QCT can alleviate asthma, and its mechanism is related to the regulation of ferroptosis, oxidative stress, and the expression of SIRT1 protein.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1747-1759"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Circulating chemerin and interleukin-6 in children with obesity: possible metabolic risk predictors.","authors":"Jie Zhang, Cai Gu, Meiling Deng, Lanshu Yang, Weixia Yang","doi":"10.21037/tp-24-264","DOIUrl":"https://doi.org/10.21037/tp-24-264","url":null,"abstract":"<p><strong>Background: </strong>As the incidence of childhood obesity has risen significantly and it can result in many complications in adulthood, this study aimed to provide a new view for early prevention of childhood obesity by detecting the levels of interleukin-6 (IL-6) and chemerin in children and studying the clinical significance.</p><p><strong>Methods: </strong>We used a case-control design. Serum chemerin and IL-6 levels were measured among 101 participants, including 50 children with obesity and 51 healthy children. Chemerin and IL-6 were correlated with metabolic parameters, and the independent determinants of chemerin and IL-6 were studied by using multivariate linear regression analysis.</p><p><strong>Results: </strong>The levels of chemerin, IL-6, body mass index (BMI), blood pressure, triglyceride (TG), low-density lipoprotein (LDL), hemoglobin A1c (HbA1c), Fins, C-peptide, homeostasis model assessment of insulin resistance (HOMA-IR), aspartate aminotransferase (AST), alanine aminotransferase (ALT), uric acid and creatinine were significantly increased in children with obesity (P<0.05). While, the levels of high-density lipoprotein (HDL) in the obese group were remarkably lower (P<0.05). The correlative analysis showed that serum chemerin and IL-6 were positively correlated with BMI, Fins, C-peptide, HOMA-IR, and AST, and chemerin was also positively correlated with systolic blood pressure, ALT, and IL-6 (P<0.05). Multivariate linear regression analysis showed that IL-6 was the independent determinant of chemerin.</p><p><strong>Conclusions: </strong>The elevated levels of serum chemerin and IL-6 in children with obesity were positively correlated with multiple metabolic indicators, suggesting that chemerin and IL-6 may be involved in the occurrence of childhood obesity and its complications, and were expected to become early warning metabolic risk predictors.</p>","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1760-1766"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142627885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic factors and surgical management in pediatric primary lung cancer: a retrospective cohort study using SEER data.","authors":"Weiming Chen, Jianxi Bai, Yifan Fang, Dianming Wu, Bing Zhang","doi":"10.21037/tp-24-174","DOIUrl":"https://doi.org/10.21037/tp-24-174","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Primary lung cancer (LC) is extremely rare in pediatric patients, making diagnosis and management particularly challenging. Currently, there are no established guidelines for treating LC in this age group, and both prognosis and treatment experiences are scarcely studied. This study aims to evaluate prognostic factors and assess the survival benefits of surgical intervention in pediatric LC patients.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) database spanning from 1988 to 2019, encompassing 337 children aged 0-19 years diagnosed with primary LC. Clinical characteristics, prognostic factors, and surgical approaches were elucidated. Prognostic markers for overall survival (OS) were evaluated through univariate and multivariate Cox proportional hazards regression models. Survival analysis between groups utilized Kaplan-Meier survival curves.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The children indicated a median age of 15 years and the female-to-male ratio was close to 1:1. The most common pathological type was carcinoid tumor (31.45%). Most of the tumors were &lt;5 cm in diameter (63.79%) or confined in situ (46.77%). The 5-year OS rate for the entire cohort was 77.9%, with pathologic classification, SEER stage, surgery, and tumor size identified as independent prognostic factors. Pulmonary/pleuropulmonary blastoma [hazards ratio (HR): 6.41; 95% confidence interval (CI): 1.69-24.35; P=0.006] or adenocarcinoma (HR: 8.82; 95% CI: 2.20-35.25; P=0.002), no surgery (HR: 2.05; 95% CI: 1.13-3.72; P=0.02), and tumor size ≥5 cm (HR: 2.87; 95% CI: 1.20-6.89; P=0.02) were associated with a worse prognosis in pediatric LC patients. In localized of SEER stage (HR: 0.15; 95% CI: 0.04-0.56; P=0.005) was associated with a better prognosis in pediatric LC patients. Common pathological types including carcinoid, pulmonary/pleuropulmonary blastoma, and mucoepidermoid carcinoma demonstrated the most favorable prognosis (P&lt;0.001). Surgery did not significantly benefit patients with American Joint Committee on Cancer (AJCC) stage IV (HR: 0.83; 95% CI: 0.42-1.62; P=0.58) or distant-stage disease (HR: 0.59; 95% CI: 0.33-1.06; P=0.06). Conversely, children with regional lymph node metastasis (HR: 0.23; 95% CI: 0.06-0.88; P=0.02) or AJCC stage III-IV (HR: 0.40; 95% CI: 0.19-0.87; P=0.02) showed improved survival following lymph node dissection. Tumor size also influenced surgical decision-making, with smaller tumors (&lt;5 cm) favoring surgical resection, including lobectomy (P&lt;0.001) or local tumor resection (P=0.03), while larger tumors exhibited advantages with less specificity regarding surgical approach (P=0.15).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;This study identified pathologic classification, SEER stage, surgery, and tumor size as independent prognostic factors for pediatric LC. For children with advanced-stage LC, surgical intervention may not extend survival time. This study un","PeriodicalId":23294,"journal":{"name":"Translational pediatrics","volume":"13 10","pages":"1671-1683"},"PeriodicalIF":1.5,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11543131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142628503","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}