Risk Factors and Outcomes of Melanoma in Children and Adolescents: A Retrospective Multicenter Study.

BACKGROUND: Pediatric melanoma presents with distinct clinical features compared to adult disease.

OBJECTIVE: Characterize risk factors and negative outcomes in pediatric melanoma.

METHODS: Multicenter retrospective study of patients under 20 years diagnosed with melanoma between 1/1/1995 - 6/30/2015 from 11 academic medical centers.

RESULTS: Melanoma was diagnosed in 317 patients, 73% of whom were diagnosed in adolescence (age ≥11). Spitzoid (31%) and superficial spreading (26%) subtypes were most common, and 11% of cases arose from congenital nevi. Sentinel lymph node biopsy was performed in 68% of cases and positive in 46%. Fatality was observed in 7% of cases. Adolescent patients with melanoma were more likely to have family history of melanoma (p=0.046) compared to controls.

LIMITATIONS: Retrospective nature, cohort size, control selection, and potential referral bias.

CONCLUSION: Pediatric melanoma has diverse clinical presentations. Better understanding of these cases and outcomes may facilitate improved risk stratification of pediatric melanoma.