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Cutaneous malignant melanoma in Swedish children and teenagers 1973–1992: a clinico‐pathological study of 130 cases
Author(s) -
Sander B.,
Karlsson P.,
Rosdahl I.,
Westermark P.,
Boeryd B.
Publication year - 1999
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(19990301)80:5<646::aid-ijc2>3.0.co;2-h
Subject(s) - medicine , melanoma , breslow thickness , pathological , cancer registry , nodular melanoma , proportional hazards model , population , cancer , young adult , surgery , breast cancer , sentinel lymph node , environmental health , cancer research
To assess whether there has been a change in histological features and prognostic factors of primary cutaneous malignant melanoma (CMM) in young individuals in Sweden, an unselected, population‐based study was undertaken; 177 cases of primary CMM in persons below 20 years of age were reported to the Swedish National Cancer Registry between 1973 and 1992. In 87% of the cases, original tumor tissue was available for histo‐pathological review. The original diagnosis was verified in 88% (n = 126) of these cases. All tumors had histological features similar to adult CMM; 17% had an associated precursor lesion. Superficial spreading melanoma (SSM) was the most common sub‐type, constituting 20/36 cases in the first decade and 59/90 in the second. Corresponding figures for nodular melanoma (NM) were 11/36 and 23/90. Only 5 melanomas in situ were diagnosed. In girls, the mean thickness of SSM decreased from 1.5 to 0.6 mm ( p < 0.001). Overall mortality was 10%, 22% in the group with CMM diagnosed 0–15 years of age and 8% in individuals 15–19 years. Fatal CMM cases diagnosed below 15 years of age (n = 4) were NM >1.6 mm thick and in subjects 15–19 years (n = 9) 44% of fatal tumors were NM with a mean thickness of 2.2 mm. Breslow index was the single most important prognostic factor. However, when known prognostic factors were adjusted for in a Cox regression analysis, young age remained an independent risk factor, with a relative death rate of 0.21 for individuals aged 15–19 compared with children <15 years of age. Int. J. Cancer 80:646–651, 1999. © 1999 Wiley‐Liss, Inc.