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Sentinel Lymph Node Biopsy in Pediatric and Adolescent Cutaneous Melanoma Patients

  • Melanomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Author information

Authors and Affiliations

  1. Sydney Melanoma Unit and Melanoma Institute Australia, Royal Prince Alfred and Mater Hospitals, Sydney, NSW, Australia

    Robert Howman-Giles MD, FRACP, DDU, Helen M. Shaw PhD, Richard A. Scolyer MD, FRCPA, FRCPath, Rajmohan Murali MBBS, FRCPA, Stanley W. McCarthy MB, BS, DCP, FRCPA, FFOP, Roger F. Uren MD, FRACP, DDU & John F. Thompson MD, FRACS, FACS

  2. Nuclear Medicine and Diagnostic Ultrasound, RPAH Medical Centre, Newtown, NSW, Australia

    Robert Howman-Giles MD, FRACP, DDU & Roger F. Uren MD, FRACP, DDU

  3. Discipline of Imaging, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia

    Robert Howman-Giles MD, FRACP, DDU

  4. Discipline of Surgery, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia

    Helen M. Shaw PhD & John F. Thompson MD, FRACS, FACS

  5. Department of Anatomical Pathology, Royal Prince Alfred Hospital, Camperdown, NSW, Australia

    Richard A. Scolyer MD, FRCPA, FRCPath, Rajmohan Murali MBBS, FRCPA, James Wilmott BSc & Stanley W. McCarthy MB, BS, DCP, FRCPA, FFOP

  6. Discipline of Pathology, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia

    Richard A. Scolyer MD, FRCPA, FRCPath, Rajmohan Murali MBBS, FRCPA & Stanley W. McCarthy MB, BS, DCP, FRCPA, FFOP

  7. Discipline of Medicine, Faculty of Medicine, University of Sydney, Sydney, NSW, Australia

    Roger F. Uren MD, FRACP, DDU

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  1. Robert Howman-Giles MD, FRACP, DDU
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  2. Helen M. Shaw PhD
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Correspondence to Robert Howman-Giles MD, FRACP, DDU.

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Howman-Giles, R., Shaw, H.M., Scolyer, R.A. et al. Sentinel Lymph Node Biopsy in Pediatric and Adolescent Cutaneous Melanoma Patients. Ann Surg Oncol 17, 138–143 (2010). https://doi.org/10.1245/s10434-009-0657-4

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  • DOI: https://doi.org/10.1245/s10434-009-0657-4

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