Saiyed Faiez K, Hamilton Emma C, Austin Mary T
Department of Pediatric Surgery, McGovern Medical School.
Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Pediatric Health Med Ther. 2017 Apr 18;8:39-45. doi: 10.2147/PHMT.S115534. eCollection 2017.
The purpose of this review is to outline recent advancements in diagnosis, treatment, and prevention of pediatric melanoma. Despite the recent decline in incidence, it continues to be the deadliest form of skin cancer in children and adolescents. Pediatric melanoma presents differently from adult melanoma; thus, the traditional asymmetry, border irregularity, color variegation, diameter >6 mm, and evolution (ABCDE) criteria have been modified to include features unique to pediatric melanoma (amelanotic, bleeding/bump, color uniformity, de novo/any diameter, evolution of mole). Surgical and medical management of pediatric melanoma continues to derive guidelines from adult melanoma treatment. However, more drug trials are being conducted to determine the specific impact of drug combinations on pediatric patients. Alongside medical and surgical treatment, prevention is a central component of battling the incidence, as ultraviolet (UV)-related mutations play a central role in the vast majority of pediatric melanoma cases. Aggressive prevention measures targeting sun safety and tanning bed usage have shown positive sun-safety behavior trends, as well as the potential to decrease melanomas that manifest later in life. As research into the field of pediatric melanoma continues to expand, a prevention paradigm needs to continue on a community-wide level.
本综述的目的是概述小儿黑色素瘤在诊断、治疗和预防方面的最新进展。尽管最近发病率有所下降,但它仍然是儿童和青少年中最致命的皮肤癌形式。小儿黑色素瘤的表现与成人黑色素瘤不同;因此,传统的不对称、边界不规则、颜色斑驳、直径>6毫米和演变(ABCDE)标准已被修改,以纳入小儿黑色素瘤特有的特征(无色素、出血/隆起、颜色均匀、新发/任何直径、痣的演变)。小儿黑色素瘤的手术和药物治疗仍继续借鉴成人黑色素瘤治疗的指南。然而,目前正在进行更多的药物试验,以确定药物组合对小儿患者的具体影响。除了药物和手术治疗外,预防是抗击发病率的核心组成部分,因为与紫外线(UV)相关的突变在绝大多数小儿黑色素瘤病例中起着核心作用。针对阳光安全和使用晒黑床的积极预防措施已显示出积极的阳光安全行为趋势,以及降低日后发生黑色素瘤的可能性。随着小儿黑色素瘤领域的研究不断扩展,预防模式需要在社区层面持续推进。