The unique clinical characteristics of melanoma diagnosed in children.
Academic Article
Overview
Research
Identity
Additional Document Info
Other
View All
Overview
abstract
BACKGROUND: Studies have demonstrated a higher rate of nodal metastases in melanoma of childhood, but there is controversy about the overall prognosis relative to adults. We describe a large single-institution experience with pediatric melanoma and assess prognostic characteristics. METHODS: Retrospective review identified 126 patients diagnosed with melanoma at <21years of age and referred for treatment from 1986 to 2011. Atypical lesions were excluded. Clinicopathologic characteristics were correlated with sentinel lymph node (SLN) status and outcomes. RESULTS: SLN biopsy was positive in 18 of 62 cases (29%). Increasing Breslow thickness correlated with a positive SLN (p<0.05). After a median follow-up of 5years, there were 27 recurrences and 20 deaths. Positive SLN patients had significantly worse recurrence-free survival (RFS, p<0.05) and significantly worse melanoma-specific survival (MSS, p=0.05) compared with negative SLN patients. The 5-year RFS and MSS for positive SLN patients were 59.5 and 77.8%, compared with 93.7 and 96.8% for negative SLN patients. Recurrences and melanoma-related deaths were often seen beyond 5years. No deaths have occurred in patients <12years, but 9.1% of patients 12-17years and 17.2% of patients 18-20years died from melanoma (p=0.291). CONCLUSIONS: Children with melanoma have higher rates of SLN metastases (29%) than adults with comparable melanomas. Despite the higher incidence of nodal metastases, survival is equal to or better than what is reported for adults. However, long-term follow-up is necessary in this population since recurrences and deaths are often seen beyond 5years.
