TY - JOUR
T1 - Melanomas in children and adolescents
T2 - Clinicopathologic features and survival outcomes
AU - El Sharouni, Mary Ann
AU - Rawson, Robert V.
AU - Potter, Alison J.
AU - Paver, Elizabeth C.
AU - Wilmott, James S.
AU - Witkamp, Arjen J.
AU - Sigurdsson, Vigfús
AU - van Diest, Paul J.
AU - Scolyer, Richard A.
AU - Thompson, John F.
AU - Lo, Serigne N.
AU - van Gils, Carla H.
N1 - Funding Information:
Funding sources: MAES was supported by a Research Fellowship Grant from the European Academy of Dermatology and Venereology (EADV). RAS and JFT were recipients of an Australian National Health and Medical Research Council (NHMRC) Program Grant (APP1093017), and RAS was the recipient of a NHMRC Practitioner Fellowship (APP1141295). This project was also supported by a research program grant from Cancer Institute New South Wales . SNL is supported by Melanoma Institute Australia . The authors gratefully acknowledge support from the BB and A Miller Foundation through the Jani Haenke Melanoma Pathology Fellowship (to AJC and ECP), the Ross Trust, the Ainsworth Foundation and the Cameron Family, as well as from colleagues at their respective institutions.
Publisher Copyright:
© 2022 American Academy of Dermatology, Inc.
PY - 2023/3
Y1 - 2023/3
N2 - Background: Melanomas in the first 2 decades of life are uncommon and poorly understood. Objective: To assess clinicopathologic features and survival of children (≤11 years) and adolescents (12-19 years) diagnosed with melanoma. Methods: A pooled cohort of 514 patients was analyzed (397 Dutch, 117 Australian; 62 children, 452 adolescents). Pathology reports were reevaluated 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, and 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% confidence interval [CI], 82.4%-100%) in children and 86.4% (95% CI, 82.7%-90.3%) in adolescents (P =.32). Ten-year OS was 100% in children and 92.7% (95% CI, 89.8%-95.8%) in adolescents (P =.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 >4 mm 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 >4 mm predicted worse survival in adolescents.
AB - Background: Melanomas in the first 2 decades of life are uncommon and poorly understood. Objective: To assess clinicopathologic features and survival of children (≤11 years) and adolescents (12-19 years) diagnosed with melanoma. Methods: A pooled cohort of 514 patients was analyzed (397 Dutch, 117 Australian; 62 children, 452 adolescents). Pathology reports were reevaluated 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, and 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% confidence interval [CI], 82.4%-100%) in children and 86.4% (95% CI, 82.7%-90.3%) in adolescents (P =.32). Ten-year OS was 100% in children and 92.7% (95% CI, 89.8%-95.8%) in adolescents (P =.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 >4 mm 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 >4 mm predicted worse survival in adolescents.
KW - adolescence
KW - age
KW - children
KW - melanoma
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85145698306&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2022.08.067
DO - 10.1016/j.jaad.2022.08.067
M3 - Article
C2 - 36509217
AN - SCOPUS:85145698306
SN - 0190-9622
VL - 88
SP - 609
EP - 616
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -