Guidelines for Diagnosis and Management of Pediatric Melanocytic Tumors
, by Jennifer K. Loukissas, M.P.P.
A multidisciplinary panel of experts, convened by the Children’s Oncology Group (COG), has published consensus guidelines for diagnostic evaluation and surgical management of pediatric melanocytic tumors. The guidelines were published October 4, 2024, in the Journal of Clinical Oncology.
This is the first paper to provide evidence-based, multidisciplinary guidance for the diagnostic evaluation and surgical management of pediatric cutaneous melanoma. The recommendations also address diagnosis and management of atypical Spitz and non-Spitz melanocytic tumors in pediatric patients.
Diagnosis of these malignancies in pediatric patients is challenging because benign and malignant melanocytic tumors may exhibit similar clinicopathologic features in this age group. The guidelines seek to address diagnostic ambiguity, improve tumor classification through the use of next generation sequencing, and minimize treatment variability.
Because of the potential morbidity and disfigurement associated with surgery in children, it is critical to minimize resection margins for pediatric melanocytic tumors to the extent possible without compromising clinical outcomes. These consensus recommendations will set the stage for future clinical trials to evaluate whether narrower surgical margins than those proposed in this consensus paper can be safely utilized in pediatric patients without impacting disease recurrence and survival.
The COG panel included experts from multiple disciplines, including cutaneous/medical/surgical oncology, dermatology, and dermatopathology. Michael R. Sargen, M.D., assistant clinical investigator in the Clinical Genetics Branch, co-chaired the working group. The consensus recommendations were based on expert opinion and supporting data from 87 peer-reviewed publications.
Reference
Sargen MR et al. Evaluation and surgical management of pediatric cutaneous melanoma and atypical Spitz and non-Spitz melanocytic tumors (melanocytomas): A report from Children’s Oncology Group. Journal of Clinical Oncology. 2024.