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The Unique Clinical Characteristics of Melanoma Diagnosed in Children

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

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.

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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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Authors and Affiliations

  1. Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Dale Han MD, Jonathan S. Zager MD, Suroosh S. Marzban MS, Christopher A. Puleo PA-C, Amod A. Sarnaik MD, Damon Reed MD, Jane L. Messina MD & Vernon K. Sondak MD

  2. Departments of Oncologic Sciences and Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Jonathan S. Zager MD, Amod A. Sarnaik MD & Vernon K. Sondak MD

  3. Department of Biostatistics, Moffitt Cancer Center, Tampa, FL, USA

    Gang Han PhD

  4. Department of Sarcoma Oncology, Moffitt Cancer Center, Tampa, FL, USA

    Damon Reed MD

  5. Department of Pediatric Oncology, All Children’s Hospital, St. Petersburg, FL, USA

    Damon Reed MD

  6. Departments of Pathology and Cell Biology and Dermatology, University of South Florida Morsani College of Medicine, Tampa, FL, USA

    Jane L. Messina MD

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  1. Dale Han MD
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  2. Jonathan S. Zager MD
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Correspondence to Vernon K. Sondak MD.

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Han, D., Zager, J.S., Han, G. et al. The Unique Clinical Characteristics of Melanoma Diagnosed in Children. Ann Surg Oncol 19, 3888–3895 (2012). https://doi.org/10.1245/s10434-012-2554-5

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  • DOI: https://doi.org/10.1245/s10434-012-2554-5

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