Department of Dermatology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
Department of Dermatology, Leiden University Medical Centre, Leiden, The Netherlands.
J Eur Acad Dermatol Venereol. 2018 Jun;32(6):956-961. doi: 10.1111/jdv.14665. Epub 2017 Nov 28.
Melanoma is rare in the first two decades of life. Trends in incidence differ across countries.
To describe incidence and relative survival of children and adolescents with melanoma in the Netherlands for children (0 through 11 years) and adolescents (12 through 19 years) separately. We hypothesized that adolescent melanoma increased in contrast to childhood melanoma, possibly due to a difference in cancer biology and sun exposure patterns.
Data on all patients of 0-19 years diagnosed between 1989 and 2013 with histologically confirmed cutaneous invasive melanoma were retrieved from the Netherlands Cancer Registry (NCR). Incidence trends were analysed with Joinpoint regression. Relative survival analysis was performed.
Between 1989 and 2013, 80 children and 544 adolescents with melanoma were registered in the NCR. Median age at diagnosis was 17 years (IQR 15-18); the female-to-male ratio was 1.7 : 1 Statistically significant incidence trends were found in the older age group (12-19 years): an increasing incidence since 1991 [annual percentage change (APC) 3.2%, 95%CI 1.3-5.1] followed by a decrease from 2005 to 2013 (APC -4.9%, 95%CI -9.6-0.0). No incidence trends for childhood melanoma were observed (APC 0.3%, 95% CI -3.0-3.8). Relative survival at 1, 5 and 10 years was 98% (95% CI 97-99), 94% (95% CI 92-96) and 90% (95% CI 87-92), respectively. Survival was worse in males and higher Breslow thickness.
Melanoma is very rare under the age of 12 with stable incidence rates. In comparison with childhood melanoma, melanomas in adolescents are more common with a decreasing trend in the past decade. Male sex and increasing Breslow thickness are associated with worse survival in paediatric melanoma patients.
黑色素瘤在生命的头二十年很少见。发病率趋势因国家而异。
分别描述荷兰儿童（0 至 11 岁）和青少年（12 至 19 岁）黑色素瘤患儿和青少年的发病率和相对生存率。我们假设青少年黑色素瘤的发病率增加，而儿童黑色素瘤的发病率则下降，这可能是由于癌症生物学和阳光暴露模式的差异。
从荷兰癌症登记处（NCR）中检索了 1989 年至 2013 年间所有经组织学证实为皮肤浸润性黑色素瘤的 0-19 岁患者的数据。使用 Joinpoint 回归分析发病率趋势。进行相对生存分析。
1989 年至 2013 年间，NCR 共登记了 80 名儿童和 544 名青少年黑色素瘤患者。诊断时的中位年龄为 17 岁（IQR 15-18）；男女比例为 1.7:1。在年龄较大的组（12-19 岁）中发现了统计学上显著的发病率趋势：自 1991 年以来发病率呈上升趋势（APC 3.2%，95%CI 1.3-5.1），随后自 2005 年至 2013 年下降（APC-4.9%，95%CI-9.6-0.0）。未观察到儿童黑色素瘤的发病趋势（APC 0.3%，95%CI-3.0-3.8）。1、5 和 10 年的相对生存率分别为 98%（95%CI 97-99）、94%（95%CI 92-96）和 90%（95%CI 87-92）。男性和更高的 Breslow 厚度与生存率较差相关。
12 岁以下黑色素瘤非常罕见，发病率稳定。与儿童黑色素瘤相比，青少年黑色素瘤更为常见，在过去十年中呈下降趋势。男性和 Breslow 厚度增加与儿童黑色素瘤患者的生存率较差相关。
