title: Sentinel lymph node biopsy is a prognostic measure in pediatric melanoma.
abstract: OBJECTIVE
  Sentinel lymph node biopsy (SLNB)-based management has been shown to improve disease-free survival in adult melanoma, but there is scant evidence regarding the utility of SLNB in pediatric melanoma.
  
  
  METHODS
  The 2004-2011 Surveillance, Epidemiology, and End Results database was queried for patients with primary cutaneous melanoma of Breslow depth>0.75mm and clinically negative nodes. Pediatric patients, defined as less than 20years of age, were grouped by whether they underwent SLNB or not. Kaplan-Meier analysis was performed to compare melanoma-specific survival (MSS) in propensity-matched groups.
  
  
  RESULTS
  310 pediatric patients met study criteria: 261 (84%) underwent SLNB, while 49 (16%) did not. There was no difference in MSS between matched children who received SLNB and those who did not (p=0.36). Among children who received SLNB, a positive SLNB was associated with worse MSS compared to a negative SLNB (89% vs. 100% at 84months, p=0.04). However, children with a positive SLNB had more favorable survival compared to patients >20years of age (88% vs. 66% at 84months, p=0.02).
  
  
  CONCLUSIONS
  SLNB does not confer a survival benefit to children with melanoma, but it provides valuable prognostic information regarding MSS.
authors.affiliation: Duke University, Department of Surgery, USA. Electronic address: jina.kim1@dm.duke.edu.
authors.forename: Jina
authors.initials: J
authors.lastname: Kim
authors.affiliation: Duke University, Department of Surgery, USA.
authors.forename: Zhifei
authors.initials: Z
authors.lastname: Sun
authors.affiliation: Duke University, Department of Surgery, USA.
authors.forename: Brian C
authors.initials: BC
authors.lastname: Gulack
authors.affiliation: Duke University, Department of Surgery, USA.
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Adam
authors.affiliation: Duke University, Department of Surgery, USA.
authors.forename: Paul J
authors.initials: PJ
authors.lastname: Mosca
authors.affiliation: Duke University, Department of Surgery, USA.
authors.forename: Henry E
authors.initials: HE
authors.lastname: Rice
authors.affiliation: Duke University, Department of Surgery, USA.
authors.forename: Elisabeth T
authors.initials: ET
authors.lastname: Tracy
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality / Q000473:pathology*; D011379:Prognosis; D018426:SEER Program; D000071036:Sentinel Lymph Node / Q000473:pathology*; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000401:mortality / Q000473:pathology*; D014481:United States; D000096142:Cutaneous Malignant Melanoma
keywords: Children; Malignant melanoma; Sentinel lymph node biopsy