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Updated: Jan 11, 2026
Spatial and Temporal Control of Murine Melanoma Initiation from Mutant Melanocyte Stem Cells
Published on: June 7, 2019
The unique clinical characteristics of melanoma diagnosed in children
Dale Han1, Jonathan S Zager, Gang Han
1Department of Cutaneous Oncology, Moffitt Cancer Center, Tampa, FL, USA.
Insights
Pediatric melanoma patients show a higher rate of positive sentinel lymph node (SLN) biopsies (29%). Despite this, their long-term survival is comparable to adults, though recurrences can occur beyond five years.
Area of Science:
- Pediatric Oncology
- Dermatology
- Surgical Oncology
Background:
- Childhood melanoma presents a higher incidence of nodal metastases compared to adult cases.
- Prognosis and survival rates for pediatric melanoma versus adult melanoma remain a subject of debate.
- This study details a significant single-institution experience with pediatric melanoma to clarify prognostic factors.
Purpose of the Study:
- To evaluate the prognostic characteristics of melanoma in patients under 21 years of age.
- To correlate clinicopathologic features with sentinel lymph node (SLN) status and patient outcomes.
- To compare the prognosis of pediatric melanoma with that of adult melanoma.
Main Methods:
- A retrospective review of 126 pediatric melanoma patients treated between 1986 and 2011.
- Exclusion of atypical lesions to focus on confirmed melanoma cases.
- Correlation of clinicopathologic characteristics with sentinel lymph node (SLN) status and survival outcomes.
Main Results:
- Sentinel lymph node (SLN) biopsy positivity was observed in 29% of pediatric melanoma cases.
- Increasing Breslow thickness was significantly associated with positive SLN status (p < 0.05).
- Patients with positive SLN status exhibited significantly worse recurrence-free survival (RFS) and melanoma-specific survival (MSS) compared to those with negative SLN status.
Conclusions:
- Pediatric melanoma demonstrates a higher rate of SLN metastases (29%) than adult melanomas.
- Despite higher nodal metastasis rates, pediatric melanoma survival is comparable or better than adult survival.
- Long-term follow-up is crucial for pediatric melanoma patients due to late recurrences and deaths observed beyond five years.
Background:
Studies have demonstrated a higher rate of nodal metastases in melanoma of childhood, but there is controversy about the overall prognosis relative to adults. We describe a large single-institution experience with pediatric melanoma and assess prognostic characteristics.
Methods:
Retrospective review identified 126 patients diagnosed with melanoma at <21 years of age and referred for treatment from 1986 to 2011. Atypical lesions were excluded. Clinicopathologic characteristics were correlated with sentinel lymph node (SLN) status and outcomes.
Results:
SLN biopsy was positive in 18 of 62 cases (29 %). Increasing Breslow thickness correlated with a positive SLN (p < 0.05). After a median follow-up of 5 years, there were 27 recurrences and 20 deaths. Positive SLN patients had significantly worse recurrence-free survival (RFS, p < 0.05) and significantly worse melanoma-specific survival (MSS, p = 0.05) compared with negative SLN patients. The 5-year RFS and MSS for positive SLN patients were 59.5 and 77.8 %, compared with 93.7 and 96.8 % for negative SLN patients. Recurrences and melanoma-related deaths were often seen beyond 5 years. No deaths have occurred in patients <12 years, but 9.1 % of patients 12-17 years and 17.2 % of patients 18-20 years died from melanoma (p = 0.291).
Conclusions:
Children with melanoma have higher rates of SLN metastases (29 %) than adults with comparable melanomas. Despite the higher incidence of nodal metastases, survival is equal to or better than what is reported for adults. However, long-term follow-up is necessary in this population since recurrences and deaths are often seen beyond 5 years.
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