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. 2015 Jun;50(6):1019-23.
doi: 10.1016/j.jpedsurg.2015.03.030. Epub 2015 Mar 14.

Early-stage non-Spitzoid cutaneous melanoma in patients younger than 22 years of age at diagnosis: long-term follow-up and survival analysis

Eric J Stanelle  1 , Klaus J Busam  2 , Barrie S Rich  1 , Emily R Christison-Lagay  1 , Ira J Dunkel  3 , Ashfaq A Marghoob  4 , Allan Halpern  4 , Daniel G Coit  5 , Michael P La Quaglia  6
Affiliations

Early-stage non-Spitzoid cutaneous melanoma in patients younger than 22 years of age at diagnosis: long-term follow-up and survival analysis

Eric J Stanelle et al. J Pediatr Surg. 2015 Jun.

Abstract

Purpose: 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.

Conclusion: 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.

Keywords: Adolescent; Melanoma; Prognosis; Recurrence.

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Figures

Fig. 1
Fig. 1
Kaplan-Meier analyses of overall survival (A), disease-specfic death (B), and recurrence (C) in our patient cohort.
Fig. 2
Fig. 2
Kaplan-Meier curves demonstrating the higher probability of disease specific death among patients with greater tumor depth (A) and higher Clark level (B).
See this image and copyright information in PMC

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