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Prognostic factors for melanoma in children and adolescents
A clinicopathologic, single-center study of 137 Patients
Article first published online: 19 AUG 2010
Copyright © 2010 American Cancer Society
Volume 116, Issue 18, pages 4334–4344, 15 September 2010
How to Cite
Paradela, S., Fonseca, E., Pita-Fernández, S., Kantrow, S. M., Diwan, A. H., Herzog, C. and Prieto, V. G. (2010), Prognostic factors for melanoma in children and adolescents. Cancer, 116: 4334–4344. doi: 10.1002/cncr.25222
- Issue published online: 3 SEP 2010
- Article first published online: 19 AUG 2010
- Manuscript Accepted: 6 DEC 2009
- Manuscript Revised: 3 NOV 2009
- Manuscript Received: 22 AUG 2009
- skin cancer;
- sentinel lymph node biopsy
Cutaneous melanoma in childhood is rare; therefore, its prognostic factors and biologic behavior and the effectiveness of adjuvant diagnostic techniques in this group remain mostly unknown.
The authors conducted a retrospective, observational study on the prognostic significance of clinical and pathologic findings from 137 cutaneous and mucosal melanomas in patients aged <18 years that were reviewed by the pathology department of a large cancer center during the period from 1992 to 2006.
Univariate analysis indicated that there was a significantly greater risk of metastases for patients who had previous nonmelanocytic malignancies, nodular histologic type, fusiform or spitzoid cytology, high Breslow thickness, vertical growth phase, high dermal mitotic activity, ulceration, and vascular invasion. Adjacent nevus and radial growth phase were associated with a better prognosis. Twelve patients (10.3%) died during follow-up. Decreased overall survival was related significantly to age >10 years, previous nonmelanocytic malignancy, high Breslow thickness, high Clark level, and the presence of metastases at diagnosis. All patients who died were aged ≥11 years, and 8 of those patients had metastases at diagnosis. In multivariate analysis, higher Breslow thickness predicted an increased risk of metastases, whereas age >10 years and the presence of metastases at diagnosis were associated with decreased survival.
Similar to adults, the detection of metastases at diagnosis in children with melanoma was 1 of the main factors that influenced overall survival. Melanomas that were detected in children aged <11 years appeared to have a less aggressive behavior than those detected in adults. Cancer 2010. © 2010 American Cancer Society.