Andrea Ferrari1, Gianni Bisogno2, Giovanni Cecchetto3, Mario Santinami4, Andrea Maurichi4, Aldo Bono5, Marco Vajna De Pava6, Paolo Pierani7, Patrizia Bertolini8, Carlo Riccardo Rossi9, Gian Luca De Salvo10. 1. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. Electronic address: andrea.ferrari@istitutotumori.mi.it. 2. Hematology-Oncology Division, Department of Pediatrics, Padova University Hospital, Padova, Italy. 3. Pediatric Surgery, Department of Pediatrics, Padova University Hospital, Padova, Italy. 4. Melanoma and Sarcoma Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 5. Day Surgery Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 6. Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Italy. 7. Department of Pediatrics, University of Ancona, Ancona, Italy. 8. Pediatric Hematology Oncology, Azienda Ospedaliera Universitaria di Parma, Parma, Italy. 9. Melanoma and Sarcoma Unit, Department of Surgery, Padova University Hospital, Padova, Italy. 10. Clinical Trials and Biostatistics Unit, IRCCS Istituto Oncologico Veneto, Padova, Italy.
Abstract
OBJECTIVE: To describe a series of cutaneous melanoma in children collected by the Italian Rare Tumors in Pediatric Age project. STUDY DESIGN: From 2000 to 2012, 54 patients younger than 18 years of age were prospectively registered and treated at 12 Italian pediatric centers on the basis of the same diagnostic/therapeutic recommendations and with the same forms to record clinical data. RESULTS: Considering the estimated annual incidence in Italy, the registered cases accounted for 30% of those expected in children and 10% of adolescents. Clinically, 47% of the tumors were amelanotic and 81% were raised, 39% of cases had tumor thickness >2 mm, and 36% had lymph node involvement. For the whole series, 5-year event-free survival and overall survival rates were 75.2% and 84.6%, respectively. Patient survival correlated with tumor stage and ulceration. No relapses were recorded for T1-2 (thickness <2 mm), N0, and stage 0-I-II cases. CONCLUSION: We suggest that the variables influencing survival in children with melanoma are the same as for adults, the clinical approach used in adults is feasible in children, and pediatric cases are more likely to have advanced disease at diagnosis but similar survival. New effective drugs are needed for advanced disease, and biological studies and international cooperative schemes are warranted.
OBJECTIVE: To describe a series of cutaneous melanoma in children collected by the Italian Rare Tumors in Pediatric Age project. STUDY DESIGN: From 2000 to 2012, 54 patients younger than 18 years of age were prospectively registered and treated at 12 Italian pediatric centers on the basis of the same diagnostic/therapeutic recommendations and with the same forms to record clinical data. RESULTS: Considering the estimated annual incidence in Italy, the registered cases accounted for 30% of those expected in children and 10% of adolescents. Clinically, 47% of the tumors were amelanotic and 81% were raised, 39% of cases had tumor thickness >2 mm, and 36% had lymph node involvement. For the whole series, 5-year event-free survival and overall survival rates were 75.2% and 84.6%, respectively. Patient survival correlated with tumor stage and ulceration. No relapses were recorded for T1-2 (thickness <2 mm), N0, and stage 0-I-II cases. CONCLUSION: We suggest that the variables influencing survival in children with melanoma are the same as for adults, the clinical approach used in adults is feasible in children, and pediatric cases are more likely to have advanced disease at diagnosis but similar survival. New effective drugs are needed for advanced disease, and biological studies and international cooperative schemes are warranted.
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