Sentinel lymph node biopsy is a prognostic measure in pediatric melanoma

Background/PurposeSentinel lymph node biopsy (SLNB)-based management has been shown to improve disease-free survival in adult melanoma, but there is scant evidence regarding the utility of SLNB in pediatric melanoma.MethodsThe 2004–2011 Surveillance, Epidemiology, and End Results database was queried for patients with primary cutaneous melanoma of Breslow depth > 0.75 mm and clinically negative nodes. Pediatric patients, defined as less than 20 years of age, were grouped by whether they underwent SLNB or not. Kaplan–Meier analysis was performed to compare melanoma-specific survival (MSS) in propensity-matched groups.Results310 pediatric patients met study criteria: 261 (84%) underwent SLNB, while 49 (16%) did not. There was no difference in MSS between matched children who received SLNB and those who did not (p = 0.36). Among children who received SLNB, a positive SLNB was associated with worse MSS compared to a negative SLNB (89% vs. 100% at 84 months, p = 0.04). However, children with a positive SLNB had more favorable survival compared to patients > 20 years of age (88% vs. 66% at 84 months, p = 0.02).ConclusionsSLNB does not confer a survival benefit to children with melanoma, but it provides valuable prognostic information regarding MSS.