Melanoma survival rates high in children, adolescents

Melanoma survival rates in children and adolescent patients were around 90% or higher, according to a study.

“Melanoma in the first two decades of life is uncommon and poorly understood,” Mary-Ann El Sharouni, MD, PhD, of the Melanoma Institute Australia at The University of Sydney and of the department of dermatology at University Medical Center Utrecht in the Netherlands, and colleagues wrote.

In the pooled cohort study, El Sharouni and colleagues assessed clinicopathologic features and survival for melanoma in children aged 11 years or younger and adolescents aged 12 to 19 years.

Of the 514 patients in the overall analysis, 397 were Dutch and 117 were Australian. There were 62 children and 452 adolescents included.

The researchers also re-evaluated pathology reports to determine melanoma subtypes, according to the findings. Recurrence-free survival (RFS) and overall survival (OS) served as the outcomes of interest.

Conventional melanoma subtypes observed in the cohort included superficial spreading, nodular, desmoplastic and acral lentiginous. These types were reported in 428 patients. In addition, 78 patients with spitzoid melanoma and eight patients with melanoma associated with a congenital nevus were included in the analysis.

Results showed a 10-year RFS rate of 91.5% (95% CI, 82.4%-100%) for children and 86.4% (95% CI, 82.7%-90.3%) in the adolescent group.

For OS at 10 years, the rates were 100% for children and 92.7% (95% CI, 89.8-95.8%) among adolescents.

There were not enough children to conduct a multivariate analysis in that group, according to the findings.

In the adolescent group, multivariable analysis results showed that two factors — ulceration status and anatomic site — carried associations with RFS and OS. In addition, poorer RFS was observed in patients with tumors with Breslow thickness greater than 4 mm.

Age, sex, mitotic index, sentinel node status and melanoma subtype failed to demonstrate any association with survival outcomes.

The study’s retrospective nature was its key limitation, according to the researchers.

“Our data suggest that adolescent melanomas are often similar to adult-type melanomas, whilst those which occur in young children frequently occur via different molecular mechanisms,” the researchers concluded. “In the future it is likely that further understanding of these molecular mechanisms and ability to classify melanomas based on their molecular characteristics will assist in further refining prognostic estimates and possibly guiding treatment for young patients with melanoma.”