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Higher rates of regional disease but improved outcomes in pediatric versus adult melanoma

articles · StayCurrentMD · Nov 09, 2021
Abstract

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

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