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. 2024 Mar 5;40(1):68.
doi: 10.1007/s00383-024-05646-8.

Regional lymph node evaluation in pediatric conventional melanoma subtype: a single-center 10-year review

Pattamon Sutthatarn  1   2 , Andrew M Davidoff  1   3 , Armita Bahrami  4 , Celine Richard  5   6 , Bhatia Shalini  7 , Teresa C Santiago  8 , Barry L Shulkin  9 , Alberto S Pappo  10 , Abdelhafeez Abdelhafeez  1
Affiliations

Regional lymph node evaluation in pediatric conventional melanoma subtype: a single-center 10-year review

Pattamon Sutthatarn et al. Pediatr Surg Int. .

Abstract

Purpose: To assess the prognostic and therapeutic significance of sentinel lymph node biopsy (SLNB) and completion lymph node dissection (CLND) in pediatric conventional melanoma (CM), while evaluating potential predictive factors for outcomes.

Methods: We conducted a retrospective analysis of medical records spanning 2009-2020, focusing on patients aged 18 or younger with localized cutaneous conventional melanoma.

Results: Among the 33 patients, SLNB detected metastasis in 57.6% of cases, with 52.6% undergoing CLND. Positive SLN patients had higher relapse risk (HR 5.92; 95% CI 1.27-27.7; P = 0.024) but similar overall survival (HR 3.19; 95% CI 0.31-33.1, P = 0.33). No significant differences in disease-free survival (DFS) and OS were found between patients who underwent CLND and those who did not (HR 1.91; 95% CI 0.49-7.43, P = 0.35, and HR 0.52; 95% CI 0.03-8.32, P = 0.64, respectively). Univariate analysis showed age at diagnosis (P = 0.02) correlated with higher recurrence risk, with a 21% hazard increase per additional year of age.

Conclusions: Positive SLN status and age at diagnosis were associated with worse DFS in CM patients. Our study did not find any prognostic or therapeutic value in CLND for pediatric melanoma. Further multicenter trials are needed to confirm our single-institution experience.

Level of evidence: Level IV.

Keywords: Melanoma; Pediatric melanoma; Sentinel lymph mode biopsy; Spitz melanoma.

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Conflict of interest statement

The authors have no conflicts to declare.

Figures

Fig. 1
Fig. 1
Flow Diagram of children diagnosed with cutaneous melanoma treated at our hospital. ATS/SM atypical spitzoid melanoma/spitzoid melanoma, CM conventional melanoma, SD standard deviation, mm millimeter, SLN sentinel lymph node, (+) positive, (−) negative
Fig. 2
Fig. 2
The Kaplan–Meier survival curves illustrate the overall survival probability for the entire cohort (upper panel) and as a function of sentinel lymph node status (lower panel)
Fig. 3
Fig. 3
Disease-free survival probability for the entire cohort (upper panel) and as a function of sentinel lymph node status (lower panel)
See this image and copyright information in PMC

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