title: 443 paediatric cases of malignant melanoma registered with the German Central Malignant Melanoma Registry between 1983 and 2011.
abstract: BACKGROUND
  Malignant melanoma is a very rare paediatric tumour. This study was performed in order to understand clinical features and prognosis of malignant melanoma in children and adolescents.
  
  
  METHODS
  443 patients ⩽ 18 years of age with malignant melanoma were prospectively registered with the German Central Malignant Melanoma Registry between 1983 and 2011. Cases were collected from 58 participating centres. 276 paediatric cases with a follow-up >3 months were evaluated for survival probabilities and prognostic factors by Kaplan-Meier method.
  
  
  RESULTS
  Age of diagnosis ranged from 3 months to 18 years (median age 16 years). The male to female ratio was 0.8 (202 male, 240 female). Most melanoma were located at the trunk (n = 195) and the lower extremity (n = 114). Patients with >3 months of follow-up (median 55 months) showed an overall survival (OS) of 94.8% in 5 years. Survival according to tumour stage was 98.5% for stage I (n = 190), 91.1% for stage II (n = 39) and 53.0% for stage III/IV tumours (n = 11). Worse outcome was seen in patients with nodular melanoma (OS 77.9%, n = 42) compared to superficial spread histotype (OS 100%, n = 138) or other histotype (OS 96.9%, n = 88) (p < 0.0001), in case of thicker tumours (Clark level IV or V, OS 87.1%, n = 84) compared to thinner tumours (Clark level I, II, III, OS 99.1%, n = 164) (p = 0.0008) and in case of ulceration (OS 65.6%, n = 17) compared to no ulceration (OS 99.2%, n = 182).
  
  
  CONCLUSIONS
  Patient and tumour characteristics in paediatric melanoma patients show no evident differences to adult melanoma cases. The same clinical approach as in adults should be used.
authors: Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany. Electronic address: ines.brecht@uk-erlangen.de.
authors: Ines B
authors: IB
authors: Brecht
authors: Center for Dermatooncology, Department of Dermatology, Central Malignant Melanoma Registry of the German Dermatological Society, University Hospital Tuebingen, Germany.
authors: Claus
authors: C
authors: Garbe
authors: Institute for Biometrics, Erlangen, Germany.
authors: Olaf
authors: O
authors: Gefeller
authors: Institute for Biometrics, Erlangen, Germany.
authors: Annette
authors: A
authors: Pfahlberg
authors: Center for Dermatooncology, Department of Dermatology, Central Malignant Melanoma Registry of the German Dermatological Society, University Hospital Tuebingen, Germany.
authors: Jürgen
authors: J
authors: Bauer
authors: Center for Dermatooncology, Department of Dermatology, Central Malignant Melanoma Registry of the German Dermatological Society, University Hospital Tuebingen, Germany.
authors: Thomas K
authors: TK
authors: Eigentler
authors: Pediatric Hematology and Oncology, University Children's Hospital Erlangen, Germany.
authors: Sonja
authors: S
authors: Offenmueller
authors: Clinic of Paediatrics, Dortmund, Germany.
authors: Dominik T
authors: DT
authors: Schneider
authors: Center for Dermatooncology, Department of Dermatology, Central Malignant Melanoma Registry of the German Dermatological Society, University Hospital Tuebingen, Germany.
authors: Ulrike
authors: U
authors: Leiter
mesh_terms: D000293:Adolescent; D017668:Age of Onset; D002648:Child; D002675:Child, Preschool; D005260:Female; D005858:Germany / Q000453:epidemiology; D006801:Humans; D007223:Infant; D008297:Male; D008545:Melanoma / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012042:Registries; D016019:Survival Analysis
keywords: Malignant melanoma; Paediatric tumours; Rare tumours; Registry