Use of sentinel lymph node biopsy for melanoma in children and adolescents

Authors

  • Mehul V. Raval MD, MS,

    Corresponding author
    1. Division of Research and Optimal Patient Care, Cancer Programs, American College of Surgeons, Chicago, Illinois
    2. Division of Pediatric Surgery, Children's Memorial Hospital, Chicago, Illinois
    3. Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    • 633 N. Saint Clair St., 22nd Floor, Chicago, IL 60611-3211. Fax: 312-202-5062.
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  • Karl Y. Bilimoria MD, MS,

    1. Division of Research and Optimal Patient Care, Cancer Programs, American College of Surgeons, Chicago, Illinois
    2. Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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  • David J. Bentrem MD, MS,

    1. Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
    2. Jesse Brown VA Medical Center, Chicago, Illinois
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  • Andrew K. Stewart MA,

    1. Division of Research and Optimal Patient Care, Cancer Programs, American College of Surgeons, Chicago, Illinois
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  • Clifford Y. Ko MD, MS, MSHS,

    1. Division of Research and Optimal Patient Care, Cancer Programs, American College of Surgeons, Chicago, Illinois
    2. Department of Surgery, University of California Los Angeles David Geffen School of Medicine and VA Greater Los Angeles Healthcare System, Los Angeles, California
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  • Marleta Reynolds MD,

    1. Division of Pediatric Surgery, Children's Memorial Hospital, Chicago, Illinois
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  • Jeffrey D. Wayne MD

    1. Division of Gastrointestinal and Oncologic Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois
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Abstract

Background

Though sentinel lymph node biopsy (SLNB) is an integral component of melanoma staging, little is known about its use in children.

Methods

Patients (0–18 years) with melanoma diagnosed from 2003 to 2007 in the National Cancer Data Base were assessed. Logistic regression models were used to identify clinicopathologic, socioeconomic, and hospital factors associated with SLNB use and lymph node metastases (LNM).

Results

Of 671 children, 68.7% underwent SLNB. SLNB utilization rates were 39.9% for T1a patients and 87.6% for T1b–T3 patients. T1b–T3 patients were more likely to undergo SLNB if they were older (OR 4.86 95% CI: 1.88–12.59) or cared for at Children's hospitals (OR 2.43 95% CI: 1.09–5.40). T1b–T3 patients were less likely to undergo SLNB if uninsured (OR 0.25 95% CI: 0.08–0.76). Of those with SLNB, 118 (25.6%) had pathologically confirmed LNM. Patients were more likely to have LNM if younger (OR 3.19 95% CI: 1.20–8.51) or having higher T stage (OR 10.38 95% CI: 4.59–23.47).

Conclusions

SLNB use for children with melanoma was associated with clinicopathologic, socioeconomic, and hospital factors. Younger patients have a higher likelihood of LNM but are the least likely to undergo SLNB. Though overall adherence appears high, there remains an opportunity for improved care for children with melanoma. J. Surg. Oncol. 2010;102:634–639. © 2010 Wiley-Liss, Inc.

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