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.