title: Cutaneous melanoma in children and adolescents: the Italian rare tumors in pediatric age project experience.
abstract: OBJECTIVE
  To describe a series of cutaneous melanoma in children collected by the Italian Rare Tumors in Pediatric Age project.
  
  
  METHODS
  From 2000 to 2012, 54 patients younger than 18 years of age were prospectively registered and treated at 12 Italian pediatric centers on the basis of the same diagnostic/therapeutic recommendations and with the same forms to record clinical data.
  
  
  RESULTS
  Considering the estimated annual incidence in Italy, the registered cases accounted for 30% of those expected in children and 10% of adolescents. Clinically, 47% of the tumors were amelanotic and 81% were raised, 39% of cases had tumor thickness >2 mm, and 36% had lymph node involvement. For the whole series, 5-year event-free survival and overall survival rates were 75.2% and 84.6%, respectively. Patient survival correlated with tumor stage and ulceration. No relapses were recorded for T1-2 (thickness <2 mm), N0, and stage 0-I-II cases.
  
  
  CONCLUSIONS
  We suggest that the variables influencing survival in children with melanoma are the same as for adults, the clinical approach used in adults is feasible in children, and pediatric cases are more likely to have advanced disease at diagnosis but similar survival. New effective drugs are needed for advanced disease, and biological studies and international cooperative schemes are warranted.
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. Electronic address: andrea.ferrari@istitutotumori.mi.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari
authors.affiliation: Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy.
authors.forename: Gianni
authors.initials: G
authors.lastname: Bisogno
authors.affiliation: Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cecchetto
authors.affiliation: Melanoma and Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Santinami
authors.affiliation: Melanoma and Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Maurichi
authors.affiliation: Day Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Aldo
authors.initials: A
authors.lastname: Bono
authors.affiliation: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Vajna De Pava
authors.affiliation: Department of Pediatrics, University of Ancona, Ancona, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pierani
authors.affiliation: Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria di Parma, Parma, Italy.
authors.forename: Patrizia
authors.initials: P
authors.lastname: Bertolini
authors.affiliation: Melanoma and Sarcoma Unit, Department of Surgery, Padova University Hospital, Padova, Italy.
authors.forename: Carlo Riccardo
authors.initials: CR
authors.lastname: Rossi
authors.affiliation: Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy.
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: De Salvo
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D008297:Male; D008545:Melanoma / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D012189:Retrospective Studies; D017678:Sex Distribution; D012878:Skin Neoplasms; D015996:Survival Rate / Q000639:trends; D000096142:Cutaneous Malignant Melanoma
keywords: AJCC; American Joint Committee on Cancer; EFS; Event-free survival; OS; Overall survival; SLNB; Sentinel lymph node biopsy; TREP; Tumori Rari in Età Pediatrica (Rare Tumors in Pediatric Age)