Abstract
Purpose
The purpose of this study was to characterize the complications associated with surgical
treatment of pediatric melanoma.
Methods
We retrospectively reviewed all pediatric patients who received surgical treatment
for melanoma at our institution between 1992 and 2010. We compared complications between
three groups: wide local excision only (WLE), WLE and sentinel lymph node biopsy (SLNB),
and WLE and completion lymph node dissection (CLND).
Results
One hundred twenty-five patients were identified: 37 patients received WLE only, 47
received WLE and SLNB, and 41 patients had WLE and CLND. Complication rates differed
between the three groups: 19% in WLE, 11% in WLE + SLNB, and 39% in WLE + CLND (P = .006). The risk of complications was significantly lower among patients having WLE + SLNB versus WLE + CLND (OR 0.19, 95% CI 0.06–0.57, P = .0032). Lymphedema was a common complication with a higher incidence in the CLND group
compared to the SLNB group (19.5% vs. 2.1%, P = .01). Complications were more frequent in inguinal compared to axillary dissections
(52.0% vs. 17.1%, P = .006).
Conclusions
In the surgical treatment of pediatric melanoma, the addition of a completion lymph
node dissection significantly increases complication risk. Thus, it is critical to
determine which patients truly benefit from this procedure.
Key words
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Article info
Publication history
Accepted:
March 8,
2013
Received:
February 17,
2013
Identification
Copyright
© 2013 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
