The Unique Clinical Characteristics of Melanoma Diagnosed in Children Academic Article uri icon

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 <21 years 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 5 years, 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 5 years. No deaths have occurred in patients <12 years, but 9.1 % of patients 12-17 years and 17.2 % of patients 18-20 years 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 5 years.

altmetric score

  • 7

author list (cited authors)

  • Han, D., Zager, J. S., Han, G., Marzban, S. S., Puleo, C. A., Sarnaik, A. A., ... Sondak, V. K.

citation count

  • 51

publication date

  • August 2012