• Steven D Scoville, Joseph R Stanek, Hannah Rinehardt, Pattamon Sutthatarn, Abdelhafeez H Abdelhafeez, Lindsay J Talbot, Marcus Malek, Harold J Leraas, Elisabeth T Tracy, Stephanie Y Chen, Eugene S Kim, Dimitra M Lotakis, Peter F Ehrlich, Juan G Favela, Hau D Le, Jacob Davidson, Claire A Wilson, Natashia M Seemann, Yasmin Osman, Nelson Piche, Victoria Hoang, Robin T Petroze, Stephanie F Polites, Katlyn G McKay, Hernan Correa, Harold N Lovvorn, Yu M Lee, Akshitha Balagani, Rohni Dasgupta, and Jennifer H Aldrink.
• Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University, Columbus, OH.
• Ann. Surg. 2024 Mar 1; 279 (3): 536541536-541.

ObjectiveTo determine the impact of nodal basin ultrasound (US) surveillance versus completion lymph node dissection (CLND) in children and adolescents with sentinel lymph node (SLN) positive melanoma.BackgroundTreatment for children and adolescents with melanoma are extrapolated from adult trials. However, there is increasing evidence that important clinical and biological differences exist between pediatric and adult melanoma.MethodsPatients ≤18 years diagnosed with cutaneous melanoma between 2010 and 2020 from 14 pediatric hospitals were included. Data extracted included demographics, histopathology, nodal basin strategies, surveillance intervals, and survival information.ResultsOf 252 patients, 90.1% (n=227) underwent SLN biopsy (SLNB), 50.9% (n=115) had at least 1 positive node. A total of 67 patients underwent CLND with 97.0% (n=65/67) performed after a positive SLNB. In contrast, 46 total patients underwent US observation of nodal basins with 78.3% (n=36/46) of these occurring after positive SLNB. Younger patients were more likely to undergo US surveillance (median age 8.5 y) than CLND (median age 11.3 y; P =0.0103). Overall, 8.9% (n=21/235) experienced disease recurrence: 6 primary, 6 nodal, and 9 distant. There was no difference in recurrence (11.1% vs 18.8%; P =0.28) or death from disease (2.2% vs 9.7%; P =0.36) for those who underwent US versus CLND, respectively.ConclusionsChildren and adolescents with cutaneous melanoma frequently have nodal metastases identified by SLN. Recurrence was more common among patients with thicker primary lesions and positive SLN. No significant differences in oncologic outcomes were observed with US surveillance and CLND following the identification of a positive SLN.Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.

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