Pediatric melanoma: Analysis of an international registry

Abstract

BACKGROUND The management of pediatric melanoma (PM) has largely been extrapolated from adult data. However, the behavior of PM appears to differ from its adult counterparts. Therefore, an international PM registry was created and analyzed. METHODS Twelve institutions contributed deidentified clinicopathologic and outcome data for patients diagnosed with PM from 1953 through 2008. RESULTS Overall survival (OS) data were reported for 365 patients with invasive PM who had adequate follow-up data. The mean age of the patients was 16 years (range 1 year-21 years). The 10-year OS rate, 80.6%, tended to vary by patient age: 100% for those aged birth to 10 years, 69.7% for those aged > 10 years to 15 years, and 79.5% for those aged > 15 years to 20 years (P =.147). Patients with melanomas measuring ≤ 1 mm had a favorable prognosis (10-year OS rate of 97%), whereas survival was lower but similar for patients with melanomas measuring > 1 mm to 2 mm, > 2 mm to 4 mm, and > 4 mm (70%, 78%, and 80%, respectively; P =.0077). Ulceration and lymph node metastasis were found to be correlated with worse survival (P =.022 and P =.017, respectively). The 10-year OS rate was 94.1% for patients with American Joint Committee on Cancer stage I disease, 79.6% for those with stage II disease, and 77.1% for patients with stage III disease (P <.001). CONCLUSIONS Tumor thickness, ulceration, lymph node status, and stage were found to be significant predictors of survival in patients with PM, similar to adult melanoma. There is a trend toward increased survival in children aged ≤ 10 years versus adolescents aged > 10 years. Further analyses are needed to probe for potential biological and behavioral differences in pediatric versus adult melanoma.

Atypical Presentation of Malignant Melanoma in a 16 Months Old Child

“…Furthermore, younger patients present with more advanced disease at the time of diagnosis [2,9,10]. A contributing factor to this may be that melanoma in this age group often do not present with the conventional signs as seen in adults.…”

“…Studies have shown a 5-year survival according to disease stage of 100% for in situ disease, 93-96% for localized disease, 68-77% for regional metastatic disease and 11-57% for distant metastatic disease [1]. A recent study by Averbook et al found that children aged ≤ 10 years with invasive melanoma present with more advanced disease at time of diagnosis but also demonstrate a trend towards increased survival compared with older pediatric cohorts [9].…”

“…Only in the youngest children (1 to 4 years) males predominate and the overall female/male ratio is 1.6 [8,9,11]. The most common primary sites of cutaneous melanoma in children are the trunk and lower extremities, except for congenital and infantile melanoma which most often occurs in the head and neck area [3,4].…”

“…The most significant prognostic factors for pediatric melanoma, like in adulthood, are: melanoma thickness, ulceration and stage at diagnosis (lymph node involvement and distant metastasis) [1,9]. Studies have shown a 5-year survival according to disease stage of 100% for in situ disease, 93-96% for localized disease, 68-77% for regional metastatic disease and 11-57% for distant metastatic disease [1].…”

Molecular Approaches for the Diagnostics of Pediatric Pigment Skin Malformations: Four Cases

“…Ранее при анализе дан-ных литературы мы выяснили, что меланома кожи у этой категории пациентов представляет собой весьма гетерогенную группу опухолей [8]. При срав-нении с меланомой кожи у взрослых они обнаружи-вают как некоторое сходство, так и существенные отличия по характеру метастазирования и выжи-ваемости больных [9,10]. Эти различия, вероятно, свидетельствуют о неодинаковом молекулярном фенотипе меланомы кожи у больных из разных воз-растных групп, поэтому при разработке комплекса маркеров для диагностики меланомы кожи у педи-атрических больных представляется допустимым использовать в качестве исходных, но требующих обязательной проверки опубликованные данные, касающиеся маркеров меланомы кожи взрослых больных, детальнее изученной, чем педиатриче-ская, в силу ее большей распространенности [11].…”