The role of routine imaging in pediatric cutaneous melanoma

Halalsheh, Hadeel; Kaste, Sue C.; Navid, Fariba; Bahrami, Armita; Shulkin, Barry L.; Rao, Bhaskar N.; Kunkel, Michelle; Artz, Nathan S.; Pappo, Alberto S.

doi:10.1002/pbc.27412

Cited by 7 publications

(4 citation statements)

References 41 publications

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“…It is difficult to ascertain whether the location of diagnosis and treatment for children and adolescents with malignant melanoma ultimately influences outcome. It is well recognized that children and adolescents diagnosed with cancer benefit from access to a specialized multidisciplinary team with ongoing systematic clinical reviews and surveillance imaging ( 21 , 28 , 29 ). A recent Italian study that analyzed nationwide hospital discharge of adolescents with melanoma found that patients were dispersed across a large number of hospitals, not always in a pediatric oncology center.…”

Section: Discussionmentioning

confidence: 99%

Malignant Melanoma in Children and Adolescents Treated in Pediatric Oncology Centers: An Australian and New Zealand Children’s Oncology Group (ANZCHOG) Study

et al. 2021

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ObjectivesUnlike adults, malignant melanoma in children and adolescents is rare. In adult melanoma, significant progress in understanding tumor biology and new treatments, including targeted therapies and immunotherapy have markedly improved overall survival. In sharp contrast, there is a paucity of data on the biology and clinical behavior of pediatric melanoma. We report a national case series of all pediatric and adolescent malignant melanoma presenting to ANZCHOG Childhood Cancer Centers in Australia and New Zealand.MethodsA retrospective, descriptive, multi-center study was undertaken to identify patients less than 18 years of age treated for cutaneous malignant melanoma over a twenty-year period (1994 to 2014). Data on clinical characteristics, histopathology, and extent of disease, treatment and follow-up are described.ResultsA total of 37 cases of malignant melanoma were identified from all of the Australasian tertiary Childhood Cancer Centers. The median age was 10 years (range 1 month – 17 years). Clinically, the most common type of lesion was pigmented, occurring in sixteen (57%) patients, whilst amelanotic was seen in 7 patients (25%). In 11 (27.9%) the Breslow thickness was greater than 4mm. A total of 11 (29.7%) patients relapsed and 90% of these died of disease. Five-year event free survival (EFS) and overall survival were 63.2 (95% CI: 40.6 – 79.1) and 67.7% (95% CI: 45.1 – 82.6) respectively.ConclusionOur data confirms that melanoma is a rare presentation of cancer to tertiary Australasian Childhood Cancer Centers with only 37 cases identified over two decades. Notably, melanoma managed in Childhood Cancer Centers is frequently at an advanced stage, with a high percentage of patients relapsing and the majority of these patients who relapsed died of disease. This study confirms previous clinical and prognostic information to support the early multidisciplinary management in Childhood Cancer Centers, in conjunction with expert adult melanoma centers, of this rare and challenging patient group.

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Section: Discussionmentioning

confidence: 99%

Malignant Melanoma in Children and Adolescents Treated in Pediatric Oncology Centers: An Australian and New Zealand Children’s Oncology Group (ANZCHOG) Study

et al. 2021

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“…Given the low risk of spread and recurrence, children with spitzoid melanoma lacking TERT promoter alterations may require minimal imaging (at diagnosis as well as at follow‐up), as shown by a recent pediatric study that compared imaging findings for spitzoid melanoma versus conventional melanoma 38 …”

Section: Diagnostic Workupmentioning

confidence: 99%

“…Given the low risk of spread and recurrence, children with spitzoid melanoma lacking TERT promoter alterations may require minimal imaging (at diagnosis as well as at follow-up), as shown by a recent pediatric study that compared imaging findings for spitzoid melanoma versus conventional melanoma. 38 The staging (and prognosis) of cutaneous melanoma are based on the American Joint Committee on Cancer (AJCC) tumor, node, metastasis (TNM) system (Figure S1), with the N classification including regional lymph nodes and also non-nodal regional disease (satellites, locally recurrent, or in-transit lesions). 39 Melanoma is a multifactorial disease and most cases are sporadic.…”

Section: Diagnostic Workupmentioning

confidence: 99%

Cutaneous melanoma in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations

Ferrari

Almaraz

Réguerre

et al. 2021

Pediatric Blood & Cancer

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Cutaneous melanoma is rare in children and, like other very rare pediatric tumors, it suffers from a shortage of knowledge and clinical expertise. The clinical management of pediatric melanoma is often challenging. Its clinical and pathological diagnosis may be difficult, and there is no standard treatment. In the absence of specific treatment guidelines, young patients are generally treated following the same principle as for adults, but concern remains about their access to clinical trials and new drugs, which have been shown to dramatically change the natural history of advanced melanoma. This paper presents the internationally recognized recommendations for the diagnosis and treatment of children and adolescents with cutaneous melanoma, established by the European Cooperative Study Group for Pediatric Rare Tumors

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“…To the Editor: Halasheh et al describe their experience with 21 pediatric patients with cutaneous melanoma and conclude that “patients with conventional melanoma should be imaged according to adult guidelines.” The authors state that according to the National Cancer Comprehensive Network (NCCN) guidelines, surveillance imaging is “recommended” at 3‐12 month intervals. Readers may mistakenly interpret the authors’ conclusions to mean that most or all pediatric patients with a history of melanoma should undergo surveillance imaging.…”

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confidence: 99%

Surveillance imaging in pediatric melanoma

McLean

2018

Pediatric Blood & Cancer

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The role of routine imaging in pediatric cutaneous melanoma

Abstract: Children with spitzoid melanoma require minimal imaging at diagnosis and follow-up. Patients with conventional MM should be imaged according to adult guidelines.

Cited by 7 publications

References 41 publications

Malignant Melanoma in Children and Adolescents Treated in Pediatric Oncology Centers: An Australian and New Zealand Children’s Oncology Group (ANZCHOG) Study

Malignant Melanoma in Children and Adolescents Treated in Pediatric Oncology Centers: An Australian and New Zealand Children’s Oncology Group (ANZCHOG) Study

Cutaneous melanoma in children and adolescents: The EXPeRT/PARTNER diagnostic and therapeutic recommendations

Surveillance imaging in pediatric melanoma

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