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Pediatric and Adolescent Melanoma: A National Cancer Data Base Update

  • Melanomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Studies suggest that the biology of pediatric and adolescent melanoma differs from that of adult disease. We report the largest series to date examining the natural history of pediatric and adolescent melanoma. We aim to elucidate the natural history of pediatric and adolescent melanoma and to examine the appropriateness of diagnostic and therapeutic modalities developed for adults and that are currently being used in children.

Methods

A retrospective cohort study was conducted of patients with an index diagnosis of cutaneous non-metastatic melanoma from 1998 to 2011 using the National Cancer Data Base (NCDB; n = 420,416). Three age-based cohorts were analyzed: 1–10 years (pediatric), 11–20 years (adolescent), and ≥21 years (adult). Multivariate analyses were used to identify factors associated with overall survival (OS).

Results

Pediatric melanoma patients have longer OS than their adolescent (hazard ratio [HR] 0.50, 95 % CI 0.25–0.98) and adult counterparts (HR 0.11, 95 % CI 0.06–0.21). Adolescents have longer OS than adults. No difference was found in OS in pediatric patients who are node-positive versus node-negative. In pediatric patients, sentinel lymph node biopsy and completion lymph node dissection are not associated with increased OS. In adolescents, nodal positivity is a significant negative prognostic indicator (HR 4.82, 95 % CI 3.38–6.87).

Conclusions

Age-based differences in melanoma outcomes warrant different considerations for diagnostic and therapeutic approaches in each group in order to maximize quality of life while minimizing complications and costs. Prospective, multicenter studies should evaluate the role of diagnostic procedures for pediatric patients.

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Acknowledgment

Jennifer C. Barnes, PhD, ELS, reviewed and edited the manuscript.

Author Contributions

Study conception and design: Joshua Hill, Patrick Lorimer, Jonathan Salo, Terry Sarantou, Richard White, and Kendall Walsh. Acquisition of Data: Joshua Hill, Patrick Lorimer, Jonathan Salo, Terry Sarantou, Richard White, Kendall Walsh, and Yimei Han. Analysis and interpretation of data: Joshua Hill, Patrick Lorimer, Jonathan Salo, Yimei Han, and James Symanowski. Drafting of manuscript: Patrick Lorimer. Critical revision: All authors. Approval of the manuscript prior to submission: All authors.

Conflict of Interest

None declared.

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Authors and Affiliations

  1. Department of Surgery, Carolinas Medical Center, Levine Cancer Institute, Charlotte, NC, USA

    Patrick D. Lorimer MD, Richard L. White MD, Kendall Walsh BA, Russell C. Kirks MD, Meghan R. Forster MD, Terry Sarantou MD, Jonathan C. Salo MD & Joshua S. Hill MD

  2. Department of Biostatistics, Carolinas Medical Center, Levine Cancer Institute, Charlotte, NC, USA

    Yimei Han MS & James Symanowski PhD

Authors
  1. Patrick D. Lorimer MD
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  2. Richard L. White MD
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Correspondence to Joshua S. Hill MD.

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Lorimer, P.D., White, R.L., Walsh, K. et al. Pediatric and Adolescent Melanoma: A National Cancer Data Base Update. Ann Surg Oncol 23, 4058–4066 (2016). https://doi.org/10.1245/s10434-016-5349-2

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  • DOI: https://doi.org/10.1245/s10434-016-5349-2

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