Comparison of Outcomes Between Surveillance Ultrasound and Completion Lymph Node Dissection in Children and Adolescents With Sentinel Lymph Node-Positive Cutaneous Melanoma

Author:

Scoville Steven D.1ORCID,Stanek Joseph R.2,Rinehardt Hannah3,Sutthatarn Pattamon4,Abdelhafeez Abdelhafeez H.4,Talbot Lindsay J.4,Malek Marcus5,Leraas Harold J.67,Tracy Elisabeth T.67,Chen Stephanie Y.8,Kim Eugene S.8,Lotakis Dimitra M.9,Ehrlich Peter F.9,Favela Juan G.10,Le Hau D.11,Davidson Jacob12,Wilson Claire A.12,Seemann Natashia M.12,Osman Yasmin13,Piche Nelson14,Hoang Victoria15,Petroze Robin T.16,Polites Stephanie F.17,McKay Katlyn G.18,Correa Hernan19,Lovvorn Harold N.20,Lee Yu M.21,Balagani Akshitha21,Dasgupta Rohni21,Aldrink Jennifer H.1

Affiliation:

1. Division of Pediatric Surgery, Department of Surgery, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH

2. Nationwide Children’s Hospital, Biostatistics, Columbus, OH

3. Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA

4. Department of Surgery, St. Jude Children’s Research Hospital, Memphis, TN

5. Department of Surgery, Division of Pediatric Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA

6. Department of Surgery, Duke University Medical Center, Durham, NC

7. Duke Children’s Hospital and Health Center, Division of Pediatric Surgery, Durham, NC

8. Division of Pediatric Surgery, Children’s Hospital Los Angeles, Los Angeles, CA

9. Section of Pediatric Surgery, University of Michigan, Ann Arbor, MI

10. Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI

11. Department of Surgery, University of Wisconsin School of Medicine and Public Health, American Family Children’s Hospital, Madison, WI

12. Children’s Hospital at London Health Sciences Centre, Division of Pediatric Surgery, London Ontario, CA

13. Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada

14. Division of Pediatric Surgery, Centre Hospitalier Universitaire Sainte-Justine, Montreal, Quebec, Cannada

15. College of Medicine, University of Florida, Gainesville, FL

16. Department of Surgery, Division of Pediatric Surgery, University of Florida, Gainesville, FL

17. Division of Pediatric Surgery, Mayo Clinic, Rochester, MN

18. Section of Surgical Sciences, Vanderbilt University Medical Center, Nashville, TN

19. Division of Pediatric Pathology, Vanderbilt University Medical Center, Nashville, TN

20. Division of Pediatric Surgery, Vanderbilt University Medical Center, Nashville, TN

21. Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH

Abstract

Objective: To determine the impact of nodal basin ultrasound (US) surveillance versus completion lymph node dissection (CLND) in children and adolescents with sentinel lymph node (SLN) positive melanoma. Background: Treatment for children and adolescents with melanoma are extrapolated from adult trials. However, there is increasing evidence that important clinical and biological differences exist between pediatric and adult melanoma. Methods: Patients ≤18 years diagnosed with cutaneous melanoma between 2010 and 2020 from 14 pediatric hospitals were included. Data extracted included demographics, histopathology, nodal basin strategies, surveillance intervals, and survival information. Results: Of 252 patients, 90.1% (n=227) underwent SLN biopsy (SLNB), 50.9% (n=115) had at least 1 positive node. A total of 67 patients underwent CLND with 97.0% (n=65/67) performed after a positive SLNB. In contrast, 46 total patients underwent US observation of nodal basins with 78.3% (n=36/46) of these occurring after positive SLNB. Younger patients were more likely to undergo US surveillance (median age 8.5 y) than CLND (median age 11.3 y; P=0.0103). Overall, 8.9% (n=21/235) experienced disease recurrence: 6 primary, 6 nodal, and 9 distant. There was no difference in recurrence (11.1% vs 18.8%; P=0.28) or death from disease (2.2% vs 9.7%; P=0.36) for those who underwent US versus CLND, respectively. Conclusions: Children and adolescents with cutaneous melanoma frequently have nodal metastases identified by SLN. Recurrence was more common among patients with thicker primary lesions and positive SLN. No significant differences in oncologic outcomes were observed with US surveillance and CLND following the identification of a positive SLN.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Surgery

Cited by 1 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. Surgical management of rare tumors (Part 1);Pediatric Blood & Cancer;2024-08-26

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