title: Early-stage non-Spitzoid cutaneous melanoma in patients younger than 22 years of age at diagnosis: long-term follow-up and survival analysis.
abstract: OBJECTIVE
  We evaluated prognostic factors among young patients with early stage melanoma, with particular attention to survival, recurrence, and development of a second primary melanoma.
  
  
  METHODS
  We retrospectively reviewed patients (age <22 years) with pathologically confirmed in-situ and stage 1 non-Spitzoid melanoma treated at our institution from 1980-2010, assessing demographics, clinical presentation, treatment, disease-specific survival, recurrence-free survival, and probability of developing a second primary melanoma.
  
  
  RESULTS
  One hundred patients with in-situ melanoma (n=16) or stage 1A (n=48) or 1B (n=36) melanoma were identified. Median age was 19.4 years (range, 11.2-21.9), and median follow-up was 7.6 years (range, 0.1-31.7). Median tumor thickness was 0.76 mm (range, 0.23-2.0). No lesions were ulcerated. All patients underwent wide local excision with negative margins, and 21 had a concomitant negative sentinel lymph node biopsy (SLNB). Sixteen patients developed recurrences, and 8 subsequently died of progressive melanoma. There were 2 non-melanoma-related deaths. Endpoints were 20-year overall survival (77.4%), melanoma-specific mortality (20.1%), recurrence rate (34.0%), and probability of developing a second primary melanoma (24.7%). Greater tumor depth and Clark level were associated with worse prognosis, but age, sex, and tumor mitotic rate were not correlated with recurrence or survival.
  
  
  CONCLUSIONS
  Among younger early-stage melanoma patients, greater lesion depth conferred higher recurrence risk and mortality. Our data did not define the role of sentinel lymph node biopsy in this group.
authors.affiliation: Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Stanelle
authors.affiliation: Dermatopathology Service, Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Klaus J
authors.initials: KJ
authors.lastname: Busam
authors.affiliation: Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Barrie S
authors.initials: BS
authors.lastname: Rich
authors.affiliation: Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Emily R
authors.initials: ER
authors.lastname: Christison-Lagay
authors.affiliation: Department of Pediatrics, Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY.
authors.forename: Ira J
authors.initials: IJ
authors.lastname: Dunkel
authors.affiliation: Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Ashfaq A
authors.initials: AA
authors.lastname: Marghoob
authors.affiliation: Department of Dermatology, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Allan
authors.initials: A
authors.lastname: Halpern
authors.affiliation: Gastric and Mixed Tumor Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.
authors.forename: Daniel G
authors.initials: DG
authors.lastname: Coit
authors.affiliation: Pediatric Surgical Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY. Electronic address: laquaglm@mskcc.org.
authors.forename: Michael P
authors.initials: MP
authors.lastname: La Quaglia
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000453:epidemiology; D009367:Neoplasm Staging; D016609:Neoplasms, Second Primary / Q000175:diagnosis / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D055815:Young Adult; D000096142:Cutaneous Malignant Melanoma
keywords: Adolescent; Melanoma; Prognosis; Recurrence
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