title: Use of sentinel lymph node biopsy and high-dose interferon in pediatric patients with high-risk melanoma: the Hospital for Sick Children experience.
abstract: BACKGROUND
  Melanoma comprises less than 3% of all cancers seen in children. Sentinel lymph node biopsy (SLNBX) is an important predictor of outcome in adult melanoma and has not been widely used in pediatrics. Furthermore, adjuvant interferon has only been rarely used in childhood high-risk disease.
  
  
  OBJECTIVE
  To review our experience with high-risk melanoma, the feasibility of SLNBX and the tolerance of high-dose interferon (HDI) therapy.
  
  
  METHODS
  We retrospectively reviewed the medical records of patients with the diagnosis of cutaneous melanoma at our center over a 10-year period.
  
  
  RESULTS
  Eleven patients were identified (median age of 12 y). Six of 10 patients who underwent SLNBX had disease in the lymph nodes and no complications from this procedure were observed. After complete lymph node dissection in these 6 patients, 1 developed wound infection and 2 had chronic lymph edema. Five patients were treated with adjuvant HDI of whom 2 patients required dose modification due to myelosuppression and liver toxicity. After a median follow-up of 26 months, 10 out of 11 patients are in remission.
  
  
  CONCLUSIONS
  SLNBX is feasible and safe in pediatric melanoma and offers the potential to identify patients at high risk for disease progression who could benefit from HDI.
authors.affiliation: Division of Hematology and Oncology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
authors.forename: Niketa C
authors.initials: NC
authors.lastname: Shah
authors.forename: J Ted
authors.initials: JT
authors.lastname: Gerstle
authors.forename: Mary
authors.initials: M
authors.lastname: Stuart
authors.forename: Carol
authors.initials: C
authors.lastname: Winter
authors.forename: Alberto
authors.initials: A
authors.lastname: Pappo
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007372:Interferons / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D020714:Maximum Tolerated Dose; D008545:Melanoma / Q000188:drug therapy* / Q000473:pathology* / Q000601:surgery; D012074:Remission Induction; D012189:Retrospective Studies; D012307:Risk Factors; D021701:Sentinel Lymph Node Biopsy / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D007372:Interferons