Malignant melanoma in children: Its management and prognosis

Rao, Bhaskar N.; Hayes, F. Ann; Pratt, Charles B.; Fleming, Irvin D.; Kumar, Akash; Lobe, Thom E.; Dilawari, Raza A.; Meyer, William H.; Parham, David M.; Custer, Monford D.

doi:10.1016/0022-3468(90)90402-u

Cited by 75 publications

(44 citation statements)

References 28 publications

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“…40 Conversely, metastases or recurrences were unusual in patients who had melanomas <1.5 mm thick. 38,39 In our series, Breslow thickness was associated significantly with metastasis and decreased overall survival; however, our patients aged 10 years had thicker primary tumors but significantly lower risk of mortality. These findings suggest the importance of early diagnosis in the pediatric population, like what occurs in adult melanoma.…”

Section: Histologic Featuresmentioning

confidence: 45%

“…14,38,39 In comparisons between adult melanomas and pediatric melanomas, 36 the latter tumors were significantly thicker. Like what we observed in the current series, analyses of 2 national cancer databases 21,39 revealed that young adults and older teenagers had thinner lesions than children ages 1 to 14 years.…”

Section: Histologic Featuresmentioning

confidence: 98%

“…6,52,53 In our series, the rate of positivity approached 40% (Table 1). Given the small number of patients, it is unclear whether these findings reflect the higher mean tumor depth 38 or are related to an inverse correlation between positive SLNB and age. 46 In contrast to findings in adults, we observed that a positive SLNB was not associated significantly with additional positive lymph nodes identified at therapeutic lymph node dissection ( 10%) 41,48,50,51 or with a greater risk of death.…”

Section: Stage and Survivalmentioning

confidence: 99%

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Prognostic factors for melanoma in children and adolescents

Paradela

Fonseca

Pita-Fernández

et al. 2010

Cancer

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BACKGROUND: 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. METHODS: 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. RESULTS: 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. CONCLUSIONS: 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;116:4334-44.

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Section: Histologic Featuresmentioning

confidence: 45%

Section: Histologic Featuresmentioning

confidence: 98%

Section: Stage and Survivalmentioning

confidence: 99%

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Prognostic factors for melanoma in children and adolescents

Paradela

Fonseca

Pita-Fernández

et al. 2010

Cancer

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“…10,11 It is much more common in adolescents, who make up 3-4% of patients with melanoma in population-based studies. 12 In our series, 83% of the children were in their second decade of life and 73% were teenagers. The incidence of melanoma in adolescents has been reported to be similar in boys and girls, [13][14][15] although we found a female preponderance in our adolescent population (65%).…”

Section: Discussionmentioning

confidence: 95%

Childhood melanoma survival

Saenz

Saenz-Badillos

Busam

et al. 1999

Cancer

110

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“…However, the diagnosis may be difficult to establish, and delays in diagnosis may delay treatment in up to 40-60% of cases in children [Melnik et al, 1986;Ridha et al, 2007;Saenz et al, 1999]. Probably as a result of the diagnostic difficulty, childhood melanomas are often thicker at the time of diagnosis than melanomas occurring in adults [Ferrari et al, 2005;Rao et al, 1990;Schmid-Wendtner et al, 2002]. As noted above, one potentially valuable approach to differentiating between melanoma and a benign condition such as a Spitz nevus is to perform a sentinel lymph node biopsy [Downard et al, 2007].…”

Section: Risk Factors/diagnosismentioning

confidence: 99%