Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy
Identifieur interne : 007699 ( Istex/Corpus ); précédent : 007698; suivant : 007700Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy
Auteurs : Felecia Cerrato ; Joseph S. Wallins ; Michelle L. Webb ; Erika R. Mccarty ; Birgitta A. Schmidt ; Brian I. LabowSource :
- Pediatric Dermatology [ 0736-8046 ] ; 2012-07.
Abstract
Abstract: The diagnosis of atypical Spitz tumor (AST) in a pediatric patient conveys an uncertain potential for malignancy. Although pediatric melanoma is rare, AST may be treated aggressively with sentinel lymph node biopsy (SLNB) and subsequent completion lymphadenectomy. These procedures have unclear therapeutic benefit and potential morbidity. We aimed to collect outcomes on children with AST treated with excision alone to assist in the management of these lesions. We queried our institution’s pathology database for AST specimens submitted between 1994 and 2009. A dermatopathologist reviewed pathology slides to confirm AST diagnosis. Clinical information was obtained from medical records, and outcomes surveys were administered to children with AST. Twenty‐nine patients met AST diagnostic criteria and were included in this study. Mean age at first excision was 9.0 ± 4.2 (range 2.3–17.5), and 19 patients underwent more than one excision procedure to achieve clear margins. No patient had SLNB. Fourteen patients (48%) with mean follow‐up time of 8.4 years (range 3.5–15.8) completed clinical outcomes surveys. Outcomes with mean follow‐up time of 2.8 years (range 0.02–8.1 years) were obtained for 10 additional patients from medical records. There were no reports of recurrence, additional lesions, or metastases in these 24 patients. We report one of the largest series of children with AST treated using excision alone and who remain disease free after a significant follow‐up period. Our data suggest that SLNB is not warranted in the routine management of pediatric AST. We recommend complete excision with clear margins and careful clinical follow‐up.
Url:
DOI: 10.1111/j.1525-1470.2011.01699.x
Links to Exploration step
ISTEX:FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66Le document en format XML
<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title><author><name sortKey="Cerrato, Felecia" sort="Cerrato, Felecia" uniqKey="Cerrato F" first="Felecia" last="Cerrato">Felecia Cerrato</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Wallins, Joseph S" sort="Wallins, Joseph S" uniqKey="Wallins J" first="Joseph S." last="Wallins">Joseph S. Wallins</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Webb, Michelle L" sort="Webb, Michelle L" uniqKey="Webb M" first="Michelle L." last="Webb">Michelle L. Webb</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Mccarty, Erika R" sort="Mccarty, Erika R" uniqKey="Mccarty E" first="Erika R." last="Mccarty">Erika R. Mccarty</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Schmidt, Birgitta A" sort="Schmidt, Birgitta A" uniqKey="Schmidt B" first="Birgitta A." last="Schmidt">Birgitta A. Schmidt</name><affiliation><mods:affiliation>Pathology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Labow, Brian I" sort="Labow, Brian I" uniqKey="Labow B" first="Brian I." last="Labow">Brian I. Labow</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66</idno><date when="2012" year="2012">2012</date><idno type="doi">10.1111/j.1525-1470.2011.01699.x</idno><idno type="url">https://api.istex.fr/document/FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66/fulltext/pdf</idno><idno type="wicri:Area/Istex/Corpus">007699</idno><idno type="wicri:explorRef" wicri:stream="Istex" wicri:step="Corpus" wicri:corpus="ISTEX">007699</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main">Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title><author><name sortKey="Cerrato, Felecia" sort="Cerrato, Felecia" uniqKey="Cerrato F" first="Felecia" last="Cerrato">Felecia Cerrato</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Wallins, Joseph S" sort="Wallins, Joseph S" uniqKey="Wallins J" first="Joseph S." last="Wallins">Joseph S. Wallins</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Webb, Michelle L" sort="Webb, Michelle L" uniqKey="Webb M" first="Michelle L." last="Webb">Michelle L. Webb</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Mccarty, Erika R" sort="Mccarty, Erika R" uniqKey="Mccarty E" first="Erika R." last="Mccarty">Erika R. Mccarty</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author><author><name sortKey="Schmidt, Birgitta A" sort="Schmidt, Birgitta A" uniqKey="Schmidt B" first="Birgitta A." last="Schmidt">Birgitta A. Schmidt</name><affiliation><mods:affiliation>Pathology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts</mods:affiliation></affiliation></author><author><name sortKey="Labow, Brian I" sort="Labow, Brian I" uniqKey="Labow B" first="Brian I." last="Labow">Brian I. Labow</name><affiliation><mods:affiliation>Departments of Plastic and Oral Surgery</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j" type="main">Pediatric Dermatology</title><title level="j" type="alt">PEDIATRIC DERMATOLOGY</title><idno type="ISSN">0736-8046</idno><idno type="eISSN">1525-1470</idno><imprint><biblScope unit="vol">29</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="448">448</biblScope><biblScope unit="page" to="453">453</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2012-07">2012-07</date></imprint><idno type="ISSN">0736-8046</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0736-8046</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract">Abstract: The diagnosis of atypical Spitz tumor (AST) in a pediatric patient conveys an uncertain potential for malignancy. Although pediatric melanoma is rare, AST may be treated aggressively with sentinel lymph node biopsy (SLNB) and subsequent completion lymphadenectomy. These procedures have unclear therapeutic benefit and potential morbidity. We aimed to collect outcomes on children with AST treated with excision alone to assist in the management of these lesions. We queried our institution’s pathology database for AST specimens submitted between 1994 and 2009. A dermatopathologist reviewed pathology slides to confirm AST diagnosis. Clinical information was obtained from medical records, and outcomes surveys were administered to children with AST. Twenty‐nine patients met AST diagnostic criteria and were included in this study. Mean age at first excision was 9.0 ± 4.2 (range 2.3–17.5), and 19 patients underwent more than one excision procedure to achieve clear margins. No patient had SLNB. Fourteen patients (48%) with mean follow‐up time of 8.4 years (range 3.5–15.8) completed clinical outcomes surveys. Outcomes with mean follow‐up time of 2.8 years (range 0.02–8.1 years) were obtained for 10 additional patients from medical records. There were no reports of recurrence, additional lesions, or metastases in these 24 patients. We report one of the largest series of children with AST treated using excision alone and who remain disease free after a significant follow‐up period. Our data suggest that SLNB is not warranted in the routine management of pediatric AST. We recommend complete excision with clear margins and careful clinical follow‐up.</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>spitz</json:string><json:string>melanoma</json:string><json:string>excision</json:string><json:string>slnb</json:string><json:string>pediatric</json:string><json:string>node</json:string><json:string>nevus</json:string><json:string>melanocytic</json:string><json:string>lesion</json:string><json:string>spitzoid</json:string><json:string>positive slnb</json:string><json:string>atypical</json:string><json:string>metastasis</json:string><json:string>sentinel lymph node biopsy</json:string><json:string>pathol</json:string><json:string>lymphadenectomy</json:string><json:string>epithelioid</json:string><json:string>surg</json:string><json:string>dermatol</json:string><json:string>malignant</json:string><json:string>mitotic</json:string><json:string>spitz tumors</json:string><json:string>clinical outcomes</json:string><json:string>medical records</json:string><json:string>complete excision</json:string><json:string>atypical spitz tumor</json:string><json:string>spitz nevus</json:string><json:string>completion lymphadenectomy</json:string><json:string>lymph</json:string><json:string>pediatric melanoma</json:string><json:string>surg pathol</json:string><json:string>extremity head</json:string><json:string>clear margins</json:string><json:string>recurrence</json:string><json:string>benign</json:string><json:string>additional lesions</json:string><json:string>family history</json:string><json:string>hospital boston</json:string><json:string>pathology reports</json:string><json:string>lower extremity</json:string><json:string>melanocytic tumors</json:string><json:string>lymph nodes</json:string><json:string>pediatric dermatology</json:string><json:string>range years</json:string><json:string>arch dermatol</json:string><json:string>atypical lesions</json:string><json:string>sentinel</json:string><json:string>biopsy</json:string><json:string>benign spitz nevi</json:string><json:string>diagnostic criteria</json:string><json:string>eosin stain</json:string><json:string>collective experience</json:string><json:string>spitz lesions</json:string><json:string>epithelioid cells</json:string><json:string>single dermatopathologist</json:string><json:string>lesion diagnosis</json:string><json:string>additional excision procedures</json:string><json:string>clear maturation</json:string><json:string>upper extremity</json:string><json:string>excision procedures</json:string><json:string>dermal proliferation</json:string><json:string>deep dermis</json:string><json:string>further involvement</json:string><json:string>largest series</json:string><json:string>melanocytic tumor</json:string><json:string>high mitotic rate</json:string><json:string>spitzoid lesion</json:string><json:string>atypical variants</json:string><json:string>risk assessment</json:string><json:string>malignant melanoma</json:string><json:string>large series</json:string><json:string>excision procedure</json:string><json:string>deep mitotic</json:string><json:string>acad dermatol</json:string></teeft></keywords><author><json:item><name>Felecia Cerrato M.P.H.</name><affiliations><json:string>Departments of Plastic and Oral Surgery</json:string></affiliations></json:item><json:item><name>Joseph S. Wallins B.S.</name><affiliations><json:string>Departments of Plastic and Oral Surgery</json:string></affiliations></json:item><json:item><name>Michelle L. Webb B.S.</name><affiliations><json:string>Departments of Plastic and Oral Surgery</json:string></affiliations></json:item><json:item><name>Erika R. McCarty B.A.</name><affiliations><json:string>Departments of Plastic and Oral Surgery</json:string></affiliations></json:item><json:item><name>Birgitta A. Schmidt M.D.</name><affiliations><json:string>Pathology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts</json:string></affiliations></json:item><json:item><name>Brian I. Labow M.D.</name><affiliations><json:string>Departments of Plastic and Oral Surgery</json:string></affiliations></json:item></author><articleId><json:string>PDE1699</json:string></articleId><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>Abstract: The diagnosis of atypical Spitz tumor (AST) in a pediatric patient conveys an uncertain potential for malignancy. Although pediatric melanoma is rare, AST may be treated aggressively with sentinel lymph node biopsy (SLNB) and subsequent completion lymphadenectomy. These procedures have unclear therapeutic benefit and potential morbidity. We aimed to collect outcomes on children with AST treated with excision alone to assist in the management of these lesions. We queried our institution’s pathology database for AST specimens submitted between 1994 and 2009. A dermatopathologist reviewed pathology slides to confirm AST diagnosis. Clinical information was obtained from medical records, and outcomes surveys were administered to children with AST. Twenty‐nine patients met AST diagnostic criteria and were included in this study. Mean age at first excision was 9.0 ± 4.2 (range 2.3–17.5), and 19 patients underwent more than one excision procedure to achieve clear margins. No patient had SLNB. Fourteen patients (48%) with mean follow‐up time of 8.4 years (range 3.5–15.8) completed clinical outcomes surveys. Outcomes with mean follow‐up time of 2.8 years (range 0.02–8.1 years) were obtained for 10 additional patients from medical records. There were no reports of recurrence, additional lesions, or metastases in these 24 patients. We report one of the largest series of children with AST treated using excision alone and who remain disease free after a significant follow‐up period. Our data suggest that SLNB is not warranted in the routine management of pediatric AST. We recommend complete excision with clear margins and careful clinical follow‐up.</abstract><qualityIndicators><score>6.366</score><pdfVersion>1.3</pdfVersion><pdfPageSize>595.276 x 782.362 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1674</abstractCharCount><pdfWordCount>3450</pdfWordCount><pdfCharCount>22926</pdfCharCount><pdfPageCount>6</pdfPageCount><abstractWordCount>243</abstractWordCount></qualityIndicators><title>Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title><genre><json:string>article</json:string></genre><host><title>Pediatric Dermatology</title><language><json:string>unknown</json:string></language><doi><json:string>10.1111/(ISSN)1525-1470</json:string></doi><issn><json:string>0736-8046</json:string></issn><eissn><json:string>1525-1470</json:string></eissn><publisherId><json:string>PDE</json:string></publisherId><volume>29</volume><issue>4</issue><pages><first>448</first><last>453</last><total>6</total></pages><genre><json:string>journal</json:string></genre></host><categories><wos><json:string>science</json:string><json:string>pediatrics</json:string><json:string>dermatology</json:string></wos><scienceMetrix><json:string>health sciences</json:string><json:string>clinical medicine</json:string><json:string>dermatology & venereal diseases</json:string></scienceMetrix></categories><publicationDate>2012</publicationDate><copyrightDate>2012</copyrightDate><doi><json:string>10.1111/j.1525-1470.2011.01699.x</json:string></doi><id>FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66</id><score>1</score><fulltext><json:item><extension>pdf</extension><original>true</original><mimetype>application/pdf</mimetype><uri>https://api.istex.fr/document/FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66/fulltext/pdf</uri></json:item><json:item><extension>zip</extension><original>false</original><mimetype>application/zip</mimetype><uri>https://api.istex.fr/document/FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main">Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title></titleStmt><publicationStmt><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><licence>© 2011 Wiley Periodicals, Inc.</licence></availability><date type="published" when="2012-07"></date></publicationStmt><notesStmt><note type="content-type" subtype="article" source="article" scheme="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</note><note type="publication-type" subtype="journal" scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main">Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title><title level="a" type="short">Outcomes in Pediatric Atypical Spitz Tumors</title><author xml:id="author-0000"><persName><forename type="first">Felecia</forename><surname>Cerrato</surname><roleName type="degree">M.P.H.</roleName></persName><affiliation>Departments of Plastic and Oral Surgery</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Joseph S.</forename><surname>Wallins</surname><roleName type="degree">B.S.</roleName></persName><affiliation>Departments of Plastic and Oral Surgery</affiliation></author><author xml:id="author-0002"><persName><forename type="first">Michelle L.</forename><surname>Webb</surname><roleName type="degree">B.S.</roleName></persName><affiliation>Departments of Plastic and Oral Surgery</affiliation></author><author xml:id="author-0003"><persName><forename type="first">Erika R.</forename><surname>McCarty</surname><roleName type="degree">B.A.</roleName></persName><affiliation>Departments of Plastic and Oral Surgery</affiliation></author><author xml:id="author-0004"><persName><forename type="first">Birgitta A.</forename><surname>Schmidt</surname><roleName type="degree">M.D.</roleName></persName><affiliation>Pathology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts<address><country key="US"></country></address></affiliation></author><author xml:id="author-0005"><persName><forename type="first">Brian I.</forename><surname>Labow</surname><roleName type="degree">M.D.</roleName></persName><affiliation>Departments of Plastic and Oral Surgery</affiliation></author><idno type="istex">FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66</idno><idno type="DOI">10.1111/j.1525-1470.2011.01699.x</idno><idno type="unit">PDE1699</idno><idno type="toTypesetVersion">file:PDE.PDE1699.pdf</idno></analytic><monogr><title level="j" type="main">Pediatric Dermatology</title><title level="j" type="alt">PEDIATRIC DERMATOLOGY</title><idno type="pISSN">0736-8046</idno><idno type="eISSN">1525-1470</idno><idno type="book-DOI">10.1111/(ISSN)1525-1470</idno><idno type="book-part-DOI">10.1111/pde.2012.29.issue-4</idno><idno type="product">PDE</idno><idno type="publisherDivision">ST</idno><imprint><biblScope unit="vol">29</biblScope><biblScope unit="issue">4</biblScope><biblScope unit="page" from="448">448</biblScope><biblScope unit="page" to="453">453</biblScope><biblScope unit="page-count">6</biblScope><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="2012-07"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><p><hi rend="bold">Abstract: </hi> The diagnosis of atypical Spitz tumor (AST) in a pediatric patient conveys an uncertain potential for malignancy. Although pediatric melanoma is rare, AST may be treated aggressively with sentinel lymph node biopsy (SLNB) and subsequent completion lymphadenectomy. These procedures have unclear therapeutic benefit and potential morbidity. We aimed to collect outcomes on children with AST treated with excision alone to assist in the management of these lesions. We queried our institution’s pathology database for AST specimens submitted between 1994 and 2009. A dermatopathologist reviewed pathology slides to confirm AST diagnosis. Clinical information was obtained from medical records, and outcomes surveys were administered to children with AST. Twenty‐nine patients met AST diagnostic criteria and were included in this study. Mean age at first excision was 9.0 ± 4.2 (range 2.3–17.5), and 19 patients underwent more than one excision procedure to achieve clear margins. No patient had SLNB. Fourteen patients (48%) with mean follow‐up time of 8.4 years (range 3.5–15.8) completed clinical outcomes surveys. Outcomes with mean follow‐up time of 2.8 years (range 0.02–8.1 years) were obtained for 10 additional patients from medical records. There were no reports of recurrence, additional lesions, or metastases in these 24 patients. We report one of the largest series of children with AST treated using excision alone and who remain disease free after a significant follow‐up period. Our data suggest that SLNB is not warranted in the routine management of pediatric AST. We recommend complete excision with clear margins and careful clinical follow‐up.</p></abstract><textClass><classCode scheme="tocHeading1">CLINICAL AND LABORATORY INVESTIGATIONS</classCode></textClass><langUsage><language ident="EN"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1525-1470</doi><issn type="print">0736-8046</issn><issn type="electronic">1525-1470</issn><idGroup><id type="product" value="PDE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="PEDIATRIC DERMATOLOGY">Pediatric Dermatology</title></titleGroup></publicationMeta><publicationMeta level="part" position="07104"><doi origin="wiley">10.1111/pde.2012.29.issue-4</doi><numberingGroup><numbering type="journalVolume" number="29">29</numbering><numbering type="journalIssue" number="4">4</numbering></numberingGroup><coverDate startDate="2012-07">July/August 2012</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="10" status="forIssue"><doi origin="wiley">10.1111/j.1525-1470.2011.01699.x</doi><idGroup><id type="unit" value="PDE1699"></id></idGroup><countGroup><count type="pageTotal" number="6"></count></countGroup><titleGroup><title type="tocHeading1">CLINICAL AND LABORATORY INVESTIGATIONS</title></titleGroup><copyright>© 2011 Wiley Periodicals, Inc.</copyright><eventGroup><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:3.1.6 mode:FullText" date="2012-09-12"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-12-30"></event><event type="publishedOnlineFinalForm" date="2012-07-03"></event><event type="firstOnline" date="2011-12-30"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.3.4 mode:FullText" date="2015-02-25"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="448">448</numbering><numbering type="pageLast" number="453">453</numbering></numberingGroup><correspondenceTo>Address correspondence to Brian I. Labow, M.D., Children’s Hospital Boston, 300 Longwood Avenue, Boston, MA 02115, or e‐mail: <email>brian.labow@childrens.harvard.edu</email>.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PDE.PDE1699.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="2"></count><count type="tableTotal" number="2"></count></countGroup><titleGroup><title type="main">Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title><title type="shortAuthors">Cerrato et al</title><title type="short">Outcomes in Pediatric Atypical Spitz Tumors</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1"><personName><givenNames>Felecia</givenNames><familyName>Cerrato</familyName><degrees>M.P.H.</degrees></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1"><personName><givenNames>Joseph S.</givenNames><familyName>Wallins</familyName><degrees>B.S.</degrees></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>Michelle L.</givenNames><familyName>Webb</familyName><degrees>B.S.</degrees></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a1"><personName><givenNames>Erika R.</givenNames><familyName>McCarty</familyName><degrees>B.A.</degrees></personName></creator><creator creatorRole="author" xml:id="cr5" affiliationRef="#a2"><personName><givenNames>Birgitta A.</givenNames><familyName>Schmidt</familyName><degrees>M.D.</degrees></personName></creator><creator creatorRole="author" xml:id="cr6" affiliationRef="#a1"><personName><givenNames>Brian I.</givenNames><familyName>Labow</familyName><degrees>M.D.</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="a1"><unparsedAffiliation>Departments of Plastic and Oral Surgery</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="US"><unparsedAffiliation>Pathology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts</unparsedAffiliation></affiliation></affiliationGroup><abstractGroup><abstract type="main" xml:lang="en"><p><b>Abstract: </b> The diagnosis of atypical Spitz tumor (AST) in a pediatric patient conveys an uncertain potential for malignancy. Although pediatric melanoma is rare, AST may be treated aggressively with sentinel lymph node biopsy (SLNB) and subsequent completion lymphadenectomy. These procedures have unclear therapeutic benefit and potential morbidity. We aimed to collect outcomes on children with AST treated with excision alone to assist in the management of these lesions. We queried our institution’s pathology database for AST specimens submitted between 1994 and 2009. A dermatopathologist reviewed pathology slides to confirm AST diagnosis. Clinical information was obtained from medical records, and outcomes surveys were administered to children with AST. Twenty‐nine patients met AST diagnostic criteria and were included in this study. Mean age at first excision was 9.0 ± 4.2 (range 2.3–17.5), and 19 patients underwent more than one excision procedure to achieve clear margins. No patient had SLNB. Fourteen patients (48%) with mean follow‐up time of 8.4 years (range 3.5–15.8) completed clinical outcomes surveys. Outcomes with mean follow‐up time of 2.8 years (range 0.02–8.1 years) were obtained for 10 additional patients from medical records. There were no reports of recurrence, additional lesions, or metastases in these 24 patients. We report one of the largest series of children with AST treated using excision alone and who remain disease free after a significant follow‐up period. Our data suggest that SLNB is not warranted in the routine management of pediatric AST. We recommend complete excision with clear margins and careful clinical follow‐up.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Outcomes in Pediatric Atypical Spitz Tumors</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy</title></titleInfo><name type="personal"><namePart type="given">Felecia</namePart><namePart type="family">Cerrato</namePart><namePart type="termsOfAddress">M.P.H.</namePart><affiliation>Departments of Plastic and Oral Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Joseph S.</namePart><namePart type="family">Wallins</namePart><namePart type="termsOfAddress">B.S.</namePart><affiliation>Departments of Plastic and Oral Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Michelle L.</namePart><namePart type="family">Webb</namePart><namePart type="termsOfAddress">B.S.</namePart><affiliation>Departments of Plastic and Oral Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Erika R.</namePart><namePart type="family">McCarty</namePart><namePart type="termsOfAddress">B.A.</namePart><affiliation>Departments of Plastic and Oral Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Birgitta A.</namePart><namePart type="family">Schmidt</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Pathology, Children’s Hospital Boston and Harvard Medical School, Boston, Massachusetts</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Brian I.</namePart><namePart type="family">Labow</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Departments of Plastic and Oral Surgery</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">2012-07</dateIssued><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">2</extent><extent unit="tables">2</extent></physicalDescription><abstract>Abstract: The diagnosis of atypical Spitz tumor (AST) in a pediatric patient conveys an uncertain potential for malignancy. Although pediatric melanoma is rare, AST may be treated aggressively with sentinel lymph node biopsy (SLNB) and subsequent completion lymphadenectomy. These procedures have unclear therapeutic benefit and potential morbidity. We aimed to collect outcomes on children with AST treated with excision alone to assist in the management of these lesions. We queried our institution’s pathology database for AST specimens submitted between 1994 and 2009. A dermatopathologist reviewed pathology slides to confirm AST diagnosis. Clinical information was obtained from medical records, and outcomes surveys were administered to children with AST. Twenty‐nine patients met AST diagnostic criteria and were included in this study. Mean age at first excision was 9.0 ± 4.2 (range 2.3–17.5), and 19 patients underwent more than one excision procedure to achieve clear margins. No patient had SLNB. Fourteen patients (48%) with mean follow‐up time of 8.4 years (range 3.5–15.8) completed clinical outcomes surveys. Outcomes with mean follow‐up time of 2.8 years (range 0.02–8.1 years) were obtained for 10 additional patients from medical records. There were no reports of recurrence, additional lesions, or metastases in these 24 patients. We report one of the largest series of children with AST treated using excision alone and who remain disease free after a significant follow‐up period. Our data suggest that SLNB is not warranted in the routine management of pediatric AST. We recommend complete excision with clear margins and careful clinical follow‐up.</abstract><relatedItem type="host"><titleInfo><title>Pediatric Dermatology</title></titleInfo><genre type="journal">journal</genre><identifier type="ISSN">0736-8046</identifier><identifier type="eISSN">1525-1470</identifier><identifier type="DOI">10.1111/(ISSN)1525-1470</identifier><identifier type="PublisherID">PDE</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>29</number></detail><detail type="issue"><caption>no.</caption><number>4</number></detail><extent unit="pages"><start>448</start><end>453</end><total>6</total></extent></part></relatedItem><identifier type="istex">FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66</identifier><identifier type="DOI">10.1111/j.1525-1470.2011.01699.x</identifier><identifier type="ArticleID">PDE1699</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2011 Wiley Periodicals, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Sante/explor/LymphedemaV1/Data/Istex/Corpus
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 007699 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Istex/Corpus/biblio.hfd -nk 007699 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Sante
|area= LymphedemaV1
|flux= Istex
|étape= Corpus
|type= RBID
|clé= ISTEX:FD04B9C64E6286A01AEF6C29B761CF8B6AF59F66
|texte= Outcomes in Pediatric Atypical Spitz Tumors Treated Without Sentinel Lymph Node Biopsy
}}
| This area was generated with Dilib version V0.6.31. |  |