Regional lymph node evaluation in pediatric conventional melanoma subtype: a single-center 10-year review

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.