Clinicopathologic Features and Survival Outcomes in Children and Adolescents With Melanoma

Abstract

BACKGROUND

Melanoma in the first two decades of life is uncommon and poorly understood.

OBJECTIVE

To assess clinicopathologic features and survival of children (≤11 years) and adolescents (12-19years) diagnosed with melanoma.

METHODS

A pooled cohort of 514 patients was analyzed (397 Dutch, 117 Australian; 62 children, 452 adolescents). Pathology reports were re-evaluated to determine melanoma subtypes. Multivariable Cox models were generated for recurrence-free survival (RFS) and overall survival (OS).

RESULTS

Melanoma subtypes were conventional melanoma (superficial spreading, nodular, desmoplastic, acral lentiginous), spitzoid melanoma, and melanoma associated with a congenital nevus in 428, 78, and 8 patients, respectively. Ten-year RFS was 91.5% (95%CI 82.4-100%) in children and 86.4% (95%CI 82.7-90.3%) in adolescents (p=0.32). Ten-year OS was 100% in children and 92.7% (95%CI 89.8-95.8%) in adolescents (p=0.09). On multivariable analysis possible only for the adolescent cohort due to the small number of children, ulceration status and anatomic site were associated with RFS and OS, whereas age, sex, mitotic index, sentinel node status and melanoma subtype were not. Breslow thickness >4mm was associated with worse RFS.

LIMITATIONS

Retrospective study.

CONCLUSIONS

Survival rates for children and adolescents with melanomas were high. Ulceration, head or neck location and Breslow thickness >4mm predicted worse survival in adolescents.

Journal of the American Academy of Dermatology

Melanomas in children and adolescents: clinicopathologic features and survival outcomes

J Am Acad Dermatol 2022 Dec 09;[EPub Ahead of Print], MA El Sharouni, RV Rawson, AJ Potter, EC Paver, JS Wilmott, AJ Witkamp, V Sigurdsson, PJ van Diest, RA Scolyer, JF Thompson, SN Lo, CH van Gils 

TAKE-HOME MESSAGE

• This retrospective cohort study involving 62 children (age, <11 years) and 452 adolescents (age, 12–19 years) with melanoma found a 10-year overall survival rate of 100% in children and 92.7% in adolescents (P = .09). Conventional melanoma was significantly more common than melanoma associated with congenital nevi or spitzoid melanoma, although the latter was more common in children. The head/neck location, tumor ulceration, and increased Breslow thickness (>4 mm) were the factors associated with worse survival outcomes in adolescents.
• The overall survival rates associated with melanoma are high in children and adolescents.

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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