Sentinel lymph node biopsy is a prognostic measure in pediatric melanoma

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• 作者：Jina Kim ; ^{jina.kim1@dm.duke.edu" class="auth_mail" title="E-mail the corresponding author} ; Zhifei Sun ; Brian C. Gulack ; Mohamed A. Adam ; Paul J. Mosca ; Henry E. Rice ; Elisabeth T. Tracy
• 关键词：Malignant melanoma ; Sentinel lymph node biopsy ; Children
• 刊名：Journal of Pediatric Surgery
• 出版年：2016
• 出版时间：June 2016
• 年：2016
• 卷：51
• 期：6
• 页码：986-990
• 全文大小：313 K

文摘

Sentinel lymph node biopsy (SLNB)-based management has been shown to improve disease-free survival in adult melanoma, but there is scant evidence regarding the utility of SLNB in pediatric melanoma.

Methods

The 2004–2011 Surveillance, Epidemiology, and End Results database was queried for patients with primary cutaneous melanoma of Breslow depth > 0.75 mm and clinically negative nodes. Pediatric patients, defined as less than 20 years of age, were grouped by whether they underwent SLNB or not. Kaplan–Meier analysis was performed to compare melanoma-specific survival (MSS) in propensity-matched groups.

Results

310 pediatric patients met study criteria: 261 (84%) underwent SLNB, while 49 (16%) did not. There was no difference in MSS between matched children who received SLNB and those who did not (p = 0.36). Among children who received SLNB, a positive SLNB was associated with worse MSS compared to a negative SLNB (89% vs. 100% at 84 months, p = 0.04). However, children with a positive SLNB had more favorable survival compared to patients > 20 years of age (88% vs. 66% at 84 months, p = 0.02).

Conclusions

SLNB does not confer a survival benefit to children with melanoma, but it provides valuable prognostic information regarding MSS.