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Annals of Surgical Oncology

, Volume 19, Issue 12, pp 3888–3895 | Cite as

The Unique Clinical Characteristics of Melanoma Diagnosed in Children

  • Dale Han
  • Jonathan S. Zager
  • Gang Han
  • Suroosh S. Marzban
  • Christopher A. Puleo
  • Amod A. Sarnaik
  • Damon Reed
  • Jane L. Messina
  • Vernon K. Sondak
Melanomas

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.

Keywords

Sentinel Lymph Node Sentinel Lymph Node Biopsy Positive Sentinel Lymph Node Breslow Thickness Completion Lymph Node Dissection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosures

VKS: Consultant/Advisory Board: Merck, Navidea (Neoprobe); JSZ: Consultant/Scientific Advisory Board for Delcath Systems, Inc. and a Consultant to IGEA; JLM: Consultant: Glaxo Smith Kline, Consultant: Durect Corporation.

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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Dale Han
    • 1
  • Jonathan S. Zager
    • 1
    • 2
  • Gang Han
    • 3
  • Suroosh S. Marzban
    • 1
  • Christopher A. Puleo
    • 1
  • Amod A. Sarnaik
    • 1
    • 2
  • Damon Reed
    • 1
    • 4
    • 5
  • Jane L. Messina
    • 1
    • 6
  • Vernon K. Sondak
    • 1
    • 2
  1. 1.Department of Cutaneous OncologyMoffitt Cancer CenterTampaUSA
  2. 2.Departments of Oncologic Sciences and SurgeryUniversity of South Florida Morsani College of MedicineTampaUSA
  3. 3.Department of BiostatisticsMoffitt Cancer CenterTampaUSA
  4. 4.Department of Sarcoma OncologyMoffitt Cancer CenterTampaUSA
  5. 5.Department of Pediatric OncologyAll Children’s HospitalSt. PetersburgUSA
  6. 6.Departments of Pathology and Cell Biology and DermatologyUniversity of South Florida Morsani College of MedicineTampaUSA

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