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. 2023 Mar;88(3):609-616.
doi: 10.1016/j.jaad.2022.08.067. Epub 2022 Dec 9.

Melanomas in children and adolescents: Clinicopathologic features and survival outcomes

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Melanomas in children and adolescents: Clinicopathologic features and survival outcomes

Mary-Ann El Sharouni et al. J Am Acad Dermatol. 2023 Mar.

Abstract

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.

Keywords: adolescence; age; children; melanoma; survival.

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Conflict of interest statement

Conflicts of interest RAS has received fees for professional services from F. Hoffmann-La Roche Ltd, Evaxion, Provectus Biopharmaceuticals Australia, Qbiotics, Merck Sharp & Dohme, GlaxoSmithKline, Bristol-Myers Squibb, Dermpedia, Novartis, Myriad, NeraCare and Amgen. JFT has received honoraria for advisory board participation from GSK, Merck Sharpe & Dohme Australia, Provectus Inc and Bristol Myers Squibb Australia, and travel and conference expenses from GSK, Provectus Inc and Novartis. The other authors have no conflicts to disclose.

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