TY - JOUR
T1 - Incidence and outcomes of pediatric extremity melanoma
T2 - A propensity score matched SEER study
AU - Parikh, Punam P.
AU - Tashiro, Jun
AU - Rubio, Gustavo A.
AU - Sola, Juan E
AU - Neville, Holly
AU - Hogan, Anthony Richard
AU - Perez, Eduardo
PY - 2018/1/1
Y1 - 2018/1/1
N2 - Background: There is a paucity of literature on treatment of melanoma in children with surgical management extrapolated from adult experience. The incidence and clinical outcomes of pediatric extremity melanoma were studied. Methods: SEER registry was analyzed between 1973 and 2010 for patients < 20 years old with extremity melanoma. Multivariate and propensity-score matched analyses were performed to identify independent predictors of survival. Results: Overall, 917 patients were identified with an age-adjusted incidence of 0.2/100,000 persons, annual percent change 0.96. Most had localized disease (77%), histology revealing melanoma-not otherwise specified (52%). Surgical procedures performed included wide local excision (50%), excisional biopsy (32%), lymphadenectomy (LA) (28%), and sentinel lymph node biopsy (SLNB) (15%). Overall, 30-year disease specific mortality was 7% with lower survival for extremity melanoma (90%), males (89%), nodular histology (69%), and upper distant disease (36%) (all P < 0.05). Posttreatment multivariate analysis revealed localized disease (OR 0.02; P = 0.006) as an independent prognosticator of survival; earlier diagnostic years 1988–1999 (OR 306.4; P = 0.001) were a negative prognosticator of survival. Propensity-score matched analysis found no difference in survival between SLNB/LA vs no sampling for regional/distant disease. Conclusions: Pediatric extremity melanoma in SEER demonstrate no survival advantage between children undergoing sampling procedures vs no sampling for regional/distant disease. Type of study: Retrospective, prognostic study. Level of evidence: III.
AB - Background: There is a paucity of literature on treatment of melanoma in children with surgical management extrapolated from adult experience. The incidence and clinical outcomes of pediatric extremity melanoma were studied. Methods: SEER registry was analyzed between 1973 and 2010 for patients < 20 years old with extremity melanoma. Multivariate and propensity-score matched analyses were performed to identify independent predictors of survival. Results: Overall, 917 patients were identified with an age-adjusted incidence of 0.2/100,000 persons, annual percent change 0.96. Most had localized disease (77%), histology revealing melanoma-not otherwise specified (52%). Surgical procedures performed included wide local excision (50%), excisional biopsy (32%), lymphadenectomy (LA) (28%), and sentinel lymph node biopsy (SLNB) (15%). Overall, 30-year disease specific mortality was 7% with lower survival for extremity melanoma (90%), males (89%), nodular histology (69%), and upper distant disease (36%) (all P < 0.05). Posttreatment multivariate analysis revealed localized disease (OR 0.02; P = 0.006) as an independent prognosticator of survival; earlier diagnostic years 1988–1999 (OR 306.4; P = 0.001) were a negative prognosticator of survival. Propensity-score matched analysis found no difference in survival between SLNB/LA vs no sampling for regional/distant disease. Conclusions: Pediatric extremity melanoma in SEER demonstrate no survival advantage between children undergoing sampling procedures vs no sampling for regional/distant disease. Type of study: Retrospective, prognostic study. Level of evidence: III.
KW - Lymph node sampling
KW - Melanoma
KW - Pediatric, survival
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U2 - 10.1016/j.jpedsurg.2018.03.006
DO - 10.1016/j.jpedsurg.2018.03.006
M3 - Article
C2 - 29602554
AN - SCOPUS:85044362570
JO - Journal of Pediatric Surgery
JF - Journal of Pediatric Surgery
SN - 0022-3468
ER -