Purpose

To assess the prognostic and therapeutic significance of sentinel lymph node biopsy (SLNB) and completion lymph node dissection (CLND) in pediatric conventional melanoma (CM), while evaluating potential predictive factors for outcomes.

Methods

We conducted a retrospective analysis of medical records spanning 2009–2020, focusing on patients aged 18 or younger with localized cutaneous conventional melanoma.

Results

Among the 33 patients, SLNB detected metastasis in 57.6% of cases, with 52.6% undergoing CLND. Positive SLN patients had higher relapse risk (HR 5.92; 95% CI 1.27–27.7; P = 0.024) but similar overall survival (HR 3.19; 95% CI 0.31–33.1, P = 0.33).

No significant differences in disease-free survival (DFS) and OS were found between patients who underwent CLND and those who did not (HR 1.91; 95% CI 0.49–7.43, P = 0.35, and HR 0.52; 95% CI 0.03–8.32, P = 0.64, respectively). Univariate analysis showed age at diagnosis (P = 0.02) correlated with higher recurrence risk, with a 21% hazard increase per additional year of age.

Conclusions

Positive SLN status and age at diagnosis were associated with worse DFS in CM patients. Our study did not find any prognostic or therapeutic value in CLND for pediatric melanoma. Further multicenter trials are needed to confirm our single-institution experience.

Level of evidence

Level IV.

目的

评估前哨淋巴结活检 (SLNB) 和完成性淋巴结清扫 (CLND) 对儿科传统黑色素瘤 (CM) 的预后和治疗意义，同时评估结果的潜在预测因素。

方法

我们对 2009 年至 2020 年的医疗记录进行了回顾性分析，重点关注 18 岁或以下患有局部皮肤传统黑色素瘤的患者。

结果

在这33名患者中，SLNB在57.6%的病例中检测到转移，其中52.6%接受了CLND。SLN 阳性患者的复发风险较高（HR 5.92；95% CI 1.27-27.7；P  = 0.024），但总生存率相似（HR 3.19；95% CI 0.31-33.1，P  = 0.33）。

接受 CLND 的患者与未接受 CLND 的患者之间，无病生存期 (DFS) 和 OS 没有显着差异（HR 1.91；95% CI 0.49–7.43，P  = 0.35，HR 0.52；95% CI 0.03–8.32） ，P  = 0.64，分别）。单变量分析显示，诊断时的年龄 ( P  = 0.02) 与较高的复发风险相关，年龄每增加一岁，风险就会增加 21%。

结论

SLN 阳性状态和诊断时年龄与 CM 患者较差的 DFS 相关。我们的研究没有发现 CLND 对儿童黑色素瘤有任何预后或治疗价值。需要进一步的多中心试验来证实我们的单一机构经验。

证据级别

四级。