Assessment of value of the sentinel lymph node biopsy in melanoma in children and adolescents and applicability of subcutaneous infusion anesthesia

Topar, Gerda; Zelger, Bernhard

doi:10.1016/j.jpedsurg.2007.05.028

Cited by 14 publications

(9 citation statements)

References 36 publications

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“…In our group of 4 patients with melanoma, 2 had metastatic disease noted by SLNB. This is in agreement with other studies, which report that pediatric melanoma will have metastatic disease in about half of cases [11,17]. The role of SLNB is well suited to addressing lesions arising from the H&N and trunk.…”

Section: Discussionsupporting

confidence: 91%

Sentinel lymph node biopsy in the pediatric population

Gow

Rapkin

Olson

et al. 2008

Journal of Pediatric Surgery

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Section: Discussionsupporting

confidence: 91%

Sentinel lymph node biopsy in the pediatric population

Gow

Rapkin

Olson

et al. 2008

Journal of Pediatric Surgery

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“…Given the small number of patients, it is unclear whether these findings reflect the higher mean tumor depth 38 or are related to an inverse correlation between positive SLNB and age. 46 In contrast to findings in adults, we observed that a positive SLNB was not associated significantly with additional positive lymph nodes identified at therapeutic lymph node dissection ( 10%) 41,48,50,51 or with a greater risk of death. 37 Similar to other reports, 18 we observed a higher SLNB-positive rate in patients aged 10 years (probably related to greater Breslow thickness), although the prognosis for survival was worse in the older group.…”

Section: Stage and Survivalcontrasting

confidence: 97%

“…39,43,44 Some authors have concluded that it can be performed safely in the pediatric population. 18,41,[43][44][45][46][47][48][49] Given its low morbidity, SLNB also may serve as an adjunct procedure in the evaluation of diagnostically difficult tumors by increasing the sensitivity of the diagnosis and providing potentially useful prognostic information. 3,26,43,45,46,[49][50][51] In previous reports, SLNB was positive for occult lymph node disease in 25% to 60% of melanomas, 18,27,43,47,48,50,51 a higher rate than the 12% to 36% in melanomas >1 mm reported in adults.…”

Section: Stage and Survivalmentioning

confidence: 99%

Prognostic factors for melanoma in children and adolescents

Paradela

Fonseca

Pita-Fernández

et al. 2010

Cancer

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BACKGROUND: Cutaneous melanoma in childhood is rare; therefore, its prognostic factors and biologic behavior and the effectiveness of adjuvant diagnostic techniques in this group remain mostly unknown. METHODS: The authors conducted a retrospective, observational study on the prognostic significance of clinical and pathologic findings from 137 cutaneous and mucosal melanomas in patients aged <18 years that were reviewed by the pathology department of a large cancer center during the period from 1992 to 2006. RESULTS: Univariate analysis indicated that there was a significantly greater risk of metastases for patients who had previous nonmelanocytic malignancies, nodular histologic type, fusiform or spitzoid cytology, high Breslow thickness, vertical growth phase, high dermal mitotic activity, ulceration, and vascular invasion. Adjacent nevus and radial growth phase were associated with a better prognosis. Twelve patients (10.3%) died during follow-up. Decreased overall survival was related significantly to age >10 years, previous nonmelanocytic malignancy, high Breslow thickness, high Clark level, and the presence of metastases at diagnosis. All patients who died were aged !11 years, and 8 of those patients had metastases at diagnosis. In multivariate analysis, higher Breslow thickness predicted an increased risk of metastases, whereas age >10 years and the presence of metastases at diagnosis were associated with decreased survival. CONCLUSIONS: Similar to adults, the detection of metastases at diagnosis in children with melanoma was 1 of the main factors that influenced overall survival. Melanomas that were detected in children aged <11 years appeared to have a less aggressive behavior than those detected in adults. Cancer 2010;116:4334-44.

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“…As with adults, there is a role for SLNB, and in children this can also serve a dual role of nodal staging and helping to establish the diagnosis of melanoma. In fact, children may actually be more likely to have a positive SLN than adults -44% for children versus 24% for adults in one study [Topar & Zelger, 2007]. Certainly, in the risk-benefit equation regarding surgical treatment, appropriate weight should be placed on the importance of early aggressive surgical extirpation and the implications of failing to do so when faced with a melanoma.…”

Section: Treatmentmentioning

confidence: 99%