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

Research output: Contribution to journalArticle

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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 melanomaspecific 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.

Original languageEnglish (US)
Pages (from-to)3888-3895
Number of pages8
JournalAnnals of surgical oncology
Volume19
Issue number12
DOIs
StatePublished - Nov 1 2012
Externally publishedYes

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Melanoma
Recurrence
Neoplasm Metastasis
Survival
Sentinel Lymph Node Biopsy
Sentinel Lymph Node
Pediatrics
Incidence
Population

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

Han, D., Zager, J. S., Han, G., Marzban, S. S., Puleo, C. A., Sarnaik, A. A., ... Sondak, V. K. (2012). The unique clinical characteristics of melanoma diagnosed in children. Annals of surgical oncology, 19(12), 3888-3895. https://doi.org/10.1245/s10434-012-2554-5

The unique clinical characteristics of melanoma diagnosed in children. / Han, Dale; Zager, Jonathan S.; Han, Gang; Marzban, Suroosh S.; Puleo, Christopher A.; Sarnaik, Amod A.; Reed, Damon; Messina, Jane L.; Sondak, Vernon K.

In: Annals of surgical oncology, Vol. 19, No. 12, 01.11.2012, p. 3888-3895.

Research output: Contribution to journalArticle

Han, D, Zager, JS, Han, G, Marzban, SS, Puleo, CA, Sarnaik, AA, Reed, D, Messina, JL & Sondak, VK 2012, 'The unique clinical characteristics of melanoma diagnosed in children', Annals of surgical oncology, vol. 19, no. 12, pp. 3888-3895. https://doi.org/10.1245/s10434-012-2554-5
Han, Dale ; Zager, Jonathan S. ; Han, Gang ; Marzban, Suroosh S. ; Puleo, Christopher A. ; Sarnaik, Amod A. ; Reed, Damon ; Messina, Jane L. ; Sondak, Vernon K. / The unique clinical characteristics of melanoma diagnosed in children. In: Annals of surgical oncology. 2012 ; Vol. 19, No. 12. pp. 3888-3895.
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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 melanomaspecific 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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T1 - The unique clinical characteristics of melanoma diagnosed in children

AU - Han, Dale

AU - Zager, Jonathan S.

AU - Han, Gang

AU - Marzban, Suroosh S.

AU - Puleo, Christopher A.

AU - Sarnaik, Amod A.

AU - Reed, Damon

AU - Messina, Jane L.

AU - Sondak, Vernon K.

PY - 2012/11/1

Y1 - 2012/11/1

N2 - 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 melanomaspecific 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.

AB - 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 melanomaspecific 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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DO - 10.1245/s10434-012-2554-5

M3 - Article

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EP - 3895

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 12

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