INTRODUCTION
Cutaneous melanoma is a very common malignancy in adults in Australia, USA, Canada and Europe with a crude incidence rate of 71, 27, 26 and 23 per 100,000/year, respectively (https://gco.iarc.fr/).
The risk of developing melanoma increases with age and is therefore considered rare in the pediatric world. However, while it is very rarely seen in children under 10 years old (annual incidence around 0.7–0.8 per million), melanoma diagnoses definitely increase after puberty, with an estimated incidence of 14 and 23 per million in adolescent males and females1, respectively.
According to the consensus promoted by the European Cooperative Study Group for Pediatric Rare
Tumors (EXPeRT) and the European Union Joint Action on Rare Cancers (JARC), “very rare pediatric cancers” are those with an annual incidence <2 per million.2 This means that melanoma must be considered rare in children, but this may not be true in adolescents.
Melanoma in young patients is clinically challenging because it might have clinical features different from those usually seen in adults (for example, it might appear amelanotic or raised)3-5 and it is pathologically challenging since it may be difficult to differentiate truly malignant lesion from atypical tumors with uncertain malignancy.6,7
Furthermore, the understanding of the disease in adolescents is limited because clinical studies on melanoma do not generally include young patients. This is of particular concern considering the huge change in the landscape of treatments for adult melanoma.8-11 In fact, the same therapeutic improvements have not been observed unfortunately in children and adolescents with melanoma, who still remain an inadequately served population.12
Against this background, we analyzed the hospital discharge records (HDRs) of adolescent inpatients newly diagnosed with cutaneous melanoma in the years 2007–2014 in Italy to identify where adolescents with melanoma are treated. Our idea is that mapping the hospitals where adolescents with melanoma are treated can contribute to identify expert centers and therefore promote collaboration for both, clinical management and clinical studies development.