Annals of Surgical Oncology

, Volume 17, Issue 1, pp 138–143

Sentinel Lymph Node Biopsy in Pediatric and Adolescent Cutaneous Melanoma Patients

  • Robert Howman-Giles
  • Helen M. Shaw
  • Richard A. Scolyer
  • Rajmohan Murali
  • James Wilmott
  • Stanley W. McCarthy
  • Roger F. Uren
  • John F. Thompson
Melanomas

DOI: 10.1245/s10434-009-0657-4

Cite this article as:
Howman-Giles, R., Shaw, H.M., Scolyer, R.A. et al. Ann Surg Oncol (2010) 17: 138. doi:10.1245/s10434-009-0657-4

Abstract

Background

The rarity of melanoma in young patients, particularly pediatric ones, has to date precluded any valid comparisons being made between young patients and adults undergoing sentinel lymph node biopsy (SLNB) for intermediate thickness localized melanoma. The present study takes advantage of the large Sydney Melanoma Unit (SMU) database to clarify this issue.

Materials and Methods

Clinical and pathologic data on pediatric and adolescent AJCC Stage I and II cutaneous melanoma patients aged <20 years undergoing SLNB at the SMU between January 1993 and February 2008 were reviewed. SLNB positivity rates and outcomes in these patients were compared with adult SMU patients.

Results

In 55 young patients, overall median tumor thickness was 1.7 mm (range, 0.6–5.2 mm) and overall SLNB positivity rate was 14 of 55 (25%), tumors tending to be thicker (median, 2.6 mm), and SLNB positivity rate higher (2 of 6; 33%) in patients aged <10 years. Of the 14 patients, 13 underwent immediate completion lymph node dissection (CLND); 2 patients had non-SLN metastases (15.4%). Only 0.7% of a total of 295 lymph nodes removed at CLND were involved with melanoma. In 14 SLNB-positive patients with follow-up data, 3 (21%) have died from melanoma after a median follow-up of 60 months, compared with 42% of 356 SLNB positive adults.

Conclusions

Although the SLNB positivity rate was higher in pediatric and adolescent melanoma patients than in adults (25% vs. 17%, respectively), non-SLN positivity and melanoma-specific death rates were low.

Copyright information

© Society of Surgical Oncology 2009

Authors and Affiliations

  • Robert Howman-Giles
    • 1
    • 2
    • 3
  • Helen M. Shaw
    • 1
    • 4
  • Richard A. Scolyer
    • 1
    • 5
    • 6
  • Rajmohan Murali
    • 1
    • 5
    • 6
  • James Wilmott
    • 5
  • Stanley W. McCarthy
    • 1
    • 5
    • 6
  • Roger F. Uren
    • 1
    • 2
    • 7
  • John F. Thompson
    • 1
    • 4
  1. 1.Sydney Melanoma Unit and Melanoma Institute AustraliaRoyal Prince Alfred and Mater HospitalsSydneyAustralia
  2. 2.Nuclear Medicine and Diagnostic UltrasoundRPAH Medical CentreNewtownAustralia
  3. 3.Discipline of Imaging, Faculty of MedicineUniversity of SydneySydneyAustralia
  4. 4.Discipline of Surgery, Faculty of MedicineUniversity of SydneySydneyAustralia
  5. 5.Department of Anatomical PathologyRoyal Prince Alfred HospitalCamperdownAustralia
  6. 6.Discipline of Pathology, Faculty of MedicineUniversity of SydneySydneyAustralia
  7. 7.Discipline of Medicine, Faculty of MedicineUniversity of SydneySydneyAustralia