Pediatric Melanoma: SLN Status & Age Impact on DFS

Pattamon Sutthatarn and the team conducted a study that aimed to examine sentinel lymph node biopsy(SLNB) and completion lymph node dissection(CLND’s) prognostic and therapeutic roles in pediatric conventional melanoma (CM), identifying potential outcome predictive factors.

The study initiated a retrospective analysis of medical records from 2009 to 2020, focusing on patients aged 18 or younger with localized cutaneous CM.

Approximately 52.6% of the 33 patients had CLND after SLNB, and 57.6% of those patients had metastases found. A significant increase in the probability of relapse was observed in positive SLN (HR 5.92; 95% CI 1.27-27.7; P = 0.024), but the variation in survival rates was not statistically significant (HR 3.19; 95% CI 0.31-33.1, P = 0.33).

The study observed no significant difference between patients with and without CLND in terms of disease-free survival (DFS) or overall survival (OS) (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). 

However, in univariate analysis, the age at diagnosis was associated with an enhanced risk of recurrence, with the risk increasing by 21% each year post-diagnosis (P= 0.02).

The study concluded that a positive SLN status and older age at diagnosis were linked to poorer DFS in CM patients. Additionally, our investigation revealed no prognostic or therapeutic benefit in CLND for pediatric melanoma. 

Further multicenter trials are warranted to validate our findings beyond our single-institution experience. 

The American Lebanese Syrian Associated Charities (ALSAC) funded this research.

Source: https://pubmed.ncbi.nlm.nih.gov/38441654/ 

Sutthatarn, P., Davidoff, A.M., Bahrami, A., et al. (2024) “Regional lymph node evaluation in pediatric conventional melanoma subtype: a single-center 10-year review.” Pediatr Surg Int 40, 68 (2024). https://doi.org/10.1007/s00383-024-05646-8.