title: 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.
authors.affiliation: Department of Surgery, Division of Surgical Oncology, MetroHealth Medical Center, Cleveland, Ohio; Department of Surgery, Case Western Reserve University, Cleveland, Ohio.
authors.forename: Bruce J
authors.initials: BJ
authors.lastname: Averbook
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Lee
authors.forename: Keith A
authors.initials: KA
authors.lastname: Delman
authors.forename: Kenneth W
authors.initials: KW
authors.lastname: Gow
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Zager
authors.forename: Vernon K
authors.initials: VK
authors.lastname: Sondak
authors.forename: Jane L
authors.initials: JL
authors.lastname: Messina
authors.forename: Michael S
authors.initials: MS
authors.lastname: Sabel
authors.forename: Mark R
authors.initials: MR
authors.lastname: Pittelkow
authors.forename: Phillip M
authors.initials: PM
authors.lastname: Ecker
authors.forename: Svetomir N
authors.initials: SN
authors.lastname: Markovic
authors.forename: Susan M
authors.initials: SM
authors.lastname: Swetter
authors.forename: Sancy A
authors.initials: SA
authors.lastname: Leachman
authors.forename: Alessandro
authors.initials: A
authors.lastname: Testori
authors.forename: Clara
authors.initials: C
authors.lastname: Curiel-Lewandrowski
authors.forename: Ronald S
authors.initials: RS
authors.lastname: Go
authors.forename: Drazen M
authors.initials: DM
authors.lastname: Jukic
authors.forename: John M
authors.initials: JM
authors.lastname: Kirkwood
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D038622:Internationality; D008297:Male; D008545:Melanoma / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012042:Registries; D012878:Skin Neoplasms / Q000401:mortality* / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma
keywords: melanoma; mitotic rate; pediatric; sentinel lymph node biopsy; survival
references.citation: J Invest Dermatol. 2009 Jul;129(7):1759-68
references.pmid: 19158841
references.citation: J Transl Med. 2010 Mar 19;8:27
references.pmid: 20302635
references.citation: Cancer. 1999 Feb 1;85(3):750-4
references.pmid: 10091749
references.citation: J Pediatr Hematol Oncol. 2000 Sep-Oct;22(5):428-32
references.pmid: 11037854
references.citation: J Pediatr Surg. 2009 Aug;44(8):1514-21
references.pmid: 19635298
references.citation: J Invest Dermatol. 2011 Mar;131(3):719-26
references.pmid: 21150923
references.citation: J Pediatr Surg. 1991 Feb;26(2):135-7
references.pmid: 2023068
references.citation: Eur J Cancer. 2001 Apr;37(6):780-4
references.pmid: 11311654
references.citation: Dermatol Surg. 2008 Feb;34(2):152-9
references.pmid: 18093205
references.citation: J Clin Oncol. 2005 Jul 20;23(21):4735-41
references.pmid: 16034049
references.citation: Arch Dermatol. 1997 Mar;133(3):295-7
references.pmid: 9080889
references.citation: Int J Cancer. 1999 Mar 1;80(5):646-51
references.pmid: 10048960
references.citation: Eur J Cancer. 2003 Dec;39(18):2651-61
references.pmid: 14642927
references.citation: Cancer. 2012 May 15;118(10):2700-7
references.pmid: 22565612
references.citation: Pediatrics. 2005 Mar;115(3):649-54
references.pmid: 15741367
references.citation: Br J Dermatol. 2009 Sep;161(3):630-4
references.pmid: 19519827
references.citation: Am J Dermatopathol. 2003 Jun;25(3):223-38
references.pmid: 12775985
references.citation: Ann Surg. 2011 Jun;253(6):1211-5
references.pmid: 21451389
references.citation: J Clin Oncol. 2012 Jun 20;30(18):2240-7
references.pmid: 22547594
references.citation: Cancer. 2010 Sep 15;116(18):4334-44
references.pmid: 20549825
references.citation: Am Surg. 1986 Mar;52(3):142-7
references.pmid: 3954260
references.citation: Melanoma Res. 2004 Aug;14(4):251-5
references.pmid: 15305154
references.citation: Cancer. 2007 Aug 1;110(3):614-24
references.pmid: 17577228
references.citation: Cancer. 1999 Dec 1;86(11 Suppl):2464-77
references.pmid: 10630172
references.citation: Cutis. 2001 May;67(5):393-6
references.pmid: 11381855
references.citation: Semin Oncol. 2002 Aug;29(4):361-9
references.pmid: 12170439
references.citation: J Clin Oncol. 2007 Apr 10;25(11):1363-8
references.pmid: 17416855