The prognostic value of tumor mitotic rate in children and adolescents with cutaneous melanoma: A retrospective cohort study

Norbertus A. Ipenburg, Serigne N. Lo, Ricardo E. Vilain, Lodewijka H. J. Holtkamp, James S. Wilmott, Omgo E. Nieweg, John F. Thompson, Richard A. Scolyer*

*Corresponding author for this work

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    Background: Mitotic rate is a strong predictor of outcome in adult patients with primary cutaneous melanoma, but for children and adolescent patients this is unknown. Objective: We sought to assess the prognostic value of primary tumor mitotic rate in children and adolescents with primary melanoma. Methods: This was a cohort study of 156 patients who were <20 years of age and who had clinically localized cutaneous melanoma. Patients <12 years of age were classified as children and those 12 to 19 years of age as adolescents. Clinicopathologic and outcome data were collected. Recurrence-free and melanoma-specific survival were calculated. Univariable and multivariable analyses were performed using Cox proportional hazard models. Results: Thirteen of 156 patients (8%) were children. The mitotic rate was ≥1/mm2 in 104 patients (67%) and correlated with increasing Breslow thickness. A positive sentinel node was found in 23 of 61 patients (38%) in whom a sentinel lymph node biopsy specimen was obtained. The median follow-up was 61 months. Five-year melanoma-specific and recurrence-free survival rates were 91% and 84%, respectively. Mitotic rate was a stronger predictor of outcome than tumor thickness and was the only factor independently associated with recurrence-free survival. Limitations: This research was conducted at a single institution and the sample size was small. Conclusion: Mitotic rate is an independent predictor of recurrence-free survival in children and adolescents with clinically localized melanoma.

    Original languageEnglish
    Pages (from-to)910-919
    Number of pages10
    JournalJournal of the American Academy of Dermatology
    Issue number4
    Publication statusPublished - Apr-2020


    • adolescent
    • children
    • dermatopathology
    • melanoma
    • mitosis
    • mitotic rate
    • oncology
    • pathology
    • pediatric
    • prognosis
    • recurrence
    • YOUNG
    • AGE

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