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Surgical treatment of children and youth with congenital melanocytic nevi: self- and proxy-reported opinions

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Abstract

Purpose

The role of surgery in the management of congenital melanocytic nevi (CMN) is controversial. Data on surgical outcomes and predictors of satisfaction remain scarce.

Methods

An online survey was employed following worldwide recruitment of youth aged 14–25 years (n = 44) and parents of children ≤ 18 years (n = 249) with CMN to query patterns of treatment and satisfaction with and opinions about the benefits of surgery.

Results

In proxy-reports, 121 of 249 (49%) and in self-reports 30 of 44 (75%) participants underwent CMN excision. The most common reasons for surgery were psychosocial determinants, aesthetic improvement, and melanoma risk reduction. The overall satisfaction with surgical management was good, although no predictors for satisfaction could be identified. Higher current age of the child was found to predict decision regret in proxy-reports. Most participants indicated that having a scar is more socially acceptable than a CMN. Opinions differed on whether surgery should be deferred until the child is old enough to be involved in the decision-making process.

Conclusions

Whether and when to perform surgery in children with CMN is a multifaceted question. Awareness of common concerns as well as risks and benefits of surgery are essential to ensure critical reflection and balanced decision-making.

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Acknowledgements

This work was supported by a grant from Nevus Outreach Inc. (http://www.nevus.org). Further, we thank everyone who participated in this study or helped with its promotion. A list of CMN patient organizations around the world can be found on http://www.naevusinternational.com or http://www.naevusglobal.org.

Funding

This work was supported by a grant from Nevus Outreach Inc. (http://www.nevus.org).

Author information

Authors and Affiliations

  1. Division of Plastic and Reconstructive Surgery, Department of Surgery, University Children’s Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland

    Kathrin Neuhaus, Miliana Vojvodic, Sophie Böttcher-Haberzeth, Clemens Schiestl & Martin Meuli

  2. Department of Psychosomatics and Psychiatry, University Children’s Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland

    Markus Landolt & Ornella Masnari

  3. Children’s Research Center, University Children’s Hospital Zurich, Steinwiesstrasse 75, 8032, Zurich, Switzerland

    Kathrin Neuhaus, Markus Landolt, Miliana Vojvodic, Sophie Böttcher-Haberzeth, Clemens Schiestl, Martin Meuli & Ornella Masnari

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  1. Kathrin Neuhaus
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by KN, ML, and OM. The first draft of the manuscript was written by KN and OM. All authors edited and commented on previous versions of the manuscript. All authors read and approved the final manuscript. All authors agree to be accountable for all aspects of the work.

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Correspondence to Kathrin Neuhaus.

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Neuhaus, K., Landolt, M., Vojvodic, M. et al. Surgical treatment of children and youth with congenital melanocytic nevi: self- and proxy-reported opinions. Pediatr Surg Int 36, 501–512 (2020). https://doi.org/10.1007/s00383-020-04633-z

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  • DOI: https://doi.org/10.1007/s00383-020-04633-z

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