Sentinel lymph node biopsy is a prognostic measure in pediatric melanoma.

BACKGROUND/PURPOSE: 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>0.75mm and clinically negative nodes. Pediatric patients, defined as less than 20years 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 84months, p=0.04). However, children with a positive SLNB had more favorable survival compared to patients >20years of age (88% vs. 66% at 84months, p=0.02). CONCLUSIONS: SLNB does not confer a survival benefit to children with melanoma, but it provides valuable prognostic information regarding MSS.

Duke Scholars

Author Paul Joseph Mosca Surgical Oncology

Author Henry Elliot Rice Surgery, Pediatric General Surgery

Author Elisabeth Tomlinson Tracy Surgery, Pediatric General Surgery