ONCOmmunity

Melanomas in children and adolescents: clinicopathologic features and survival outcomes.

By: Mary-Ann El Sharouni, Robert V Rawson, Alison J Potter, Elizabeth C Paver, James S Wilmott, Arjen J Witkamp, Vigfús Sigurdsson, Paul J van Diest, Richard A Scolyer, John F Thompson, Serigne N Lo, Carla H van Gils

Melanoma Institute Australia, The University of Sydney, Sydney, NSW, Australia; Department of Dermatology, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands.
2022-3-21; doi: 10.1016/j.jaad.2022.08.067

Abstract

Background

Melanoma in the first two decades of life is uncommon and poorly understood.

Objective

To assess clinicopathologic features and survival of children (≤11 years) and adolescents (12-19years) diagnosed with melanoma.

Methods

A pooled cohort of 514 patients was analyzed (397 Dutch, 117 Australian; 62 children, 452 adolescents). Pathology reports were re-evaluated to determine melanoma subtypes. Multivariable Cox models were generated for recurrence-free survival (RFS) and overall survival (OS).

Results

Melanoma subtypes were conventional melanoma (superficial spreading, nodular, desmoplastic, acral lentiginous), spitzoid melanoma, and melanoma associated with a congenital nevus in 428, 78, and 8 patients, respectively. Ten-year RFS was 91.5% (95%CI 82.4-100%) in children and 86.4% (95%CI 82.7-90.3%) in adolescents (p=0.32). Ten-year OS was 100% in children and 92.7% (95%CI 89.8-95.8%) in adolescents (p=0.09). On multivariable analysis possible only for the adolescent cohort due to the small number of children, ulceration status and anatomic site were associated with RFS and OS, whereas age, sex, mitotic index, sentinel node status and melanoma subtype were not. Breslow thickness >4mm was associated with worse RFS.

Limitations

Retrospective study.

Conclusions

Survival rates for children and adolescents with melanomas were high. Ulceration, head or neck location and Breslow thickness >4mm predicted worse survival in adolescents.