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Does Tumor Mitotic Rate Predict Survival Outcomes in Children With Melanoma?

By: Cordi Craig
Posted: Monday, January 20, 2020

Although mitotic rate is a strong predictor of survival outcomes among adult patients with primary cutaneous melanoma, the relationship among children and adolescent patients remains unknown, according to Richard A. Scolyer, MD, of the Melanoma Institute Australia, Sydney, and colleagues. A retrospective cohort study, published in the Journal of the American Academy of Dermatology, found that mitotic rate also seems to be an independent predictor of recurrence-free survival among pediatric patients with clinically localized melanoma.

“Our study indicates that mitotic rate is an important prognostic feature for recurrence-free survival in children and adolescents who develop melanoma, and it is therefore essential that this parameter be assessed and reported in the primary tumors of all young melanoma patients,” the investigators stated.

The research team retrospectively studied 156 patients younger than age 20 with clinically localized cutaneous melanoma. The patient pool was stratified into groups classified as child (< 12 years; n = 13) and adolescent (12–18 years; n = 143). The median follow-up was 61 months.

Mitotic rate (P < .001) was the strongest independent predictor of recurrence-free survival. Breslow thickness (P = .001) and melanoma subtype (P = .04) were also significantly related to survival. Disease recurrence was recorded in 28 patients (18%), and 16 patients (10%) died of melanoma. Of the 61 patients who underwent sentinel node biopsy, a positive sentinel node was found in 23 patients (38%). The 5-year melanoma-specific survival was 91%, and the recurrence-free survival was 84%. The researchers concluded that a larger sample size is required to confirm and validate the results—more specifically, a collaborative study that includes multiple melanoma centers. 

Disclosure: For full disclosures of the study authors, visit

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