Higher rates of regional disease but improved outcomes in pediatric versus adult melanoma
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In brief
In brief
Retrospective analysis of 328,949 melanoma patients from the National Cancer Database (2012-2017) comparing pediatric and adult presentations. Despite children presenting with thicker tumors and higher rates of regional disease, the study examines nodal management patterns and survival outcomes in pediatric melanoma.
Written by the GCMD Library team from the article.
Background
Malignant melanoma is rare in the pediatric population and management is largely extrapolated from adult guidelines. Adult data have shown that immediate completion lymph node dissection (CLND) does not improve overall survival in selected patients with clinically node negative, sentinel lymph node-positive disease. Current nodal management in children is unknown.
Methods
The National Cancer Database (NCDB) was queried for patients with melanoma from 2012-2017 and patients categorized as pediatric (≤18 years, n=962) or adult (n=327,987). Factors associated with CLND in children with positive SLNB were evaluated in multivariable analysis. Kaplan-Meier survival analysis was performed.
Results
Compared to adults, children present with thicker primary tumors (T3 or T4 26.5% vs 15.5%, p