Critical appraisal:Berk DR, LaBuz E, Dadras SS, Johnson DL, Swetter SM 2010

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Critical Appraisal

Article being appraised

Berk DR, LaBuz E, Dadras SS, Johnson DL, Swetter SM. Melanoma and melanocytic tumors of uncertain malignant potential in children, adolescents and young adults--the Stanford experience 1995-2008. Pediatr Dermatol 2010 May;27(3):244-54 Available from: http://www.ncbi.nlm.nih.gov/pubmed/20403119.


Applicable clinical question

Key Facts

Study Design

cohort study

Study aims:

To report the experience with melanoma and MelTUMPs in patients aged 21 years and younger from 1995 to 2008.

Number of Patients:

25

All 25 patients are under the age of 21:

 13 patients with melanoma

 7 with MELTUMP
Reported outcome(s):

Clinical characteristics of patients
Ulceration⁄Mitoses
Recurrence
Depth (mm)

Results of outcome(s):

 MELTUMP:
o Primary treatment for all children diagnosed with MELTUMP was wide local excision. 6/7 also had sentinel or elective lymph node dissection and 1 had adjuvant high-dose interferon (HDI) therapy.
o All patients diagnosed with MELTUMP had no evidence of disease (at varying follow-ups, range 20 months to 78 months)
o No MELTUMP patients were diagnosed with in-transit
o or visceral metastasis
o The overall survival rate for MELTUMP is 100%, with no recurrences other than one local recurrence of a MELTUMP in one patient’s scar.
 Atypical Spitz Nevi (ASN)
o Primary treatment for all children diagnosed with ASN was wide local excision.
o All patients diagnosed with ASN had no evidence of disease (at varying follow ups, range 1 month – 35 months)

Includes an economic evaluation

no

Evidence ratings

Level of evidence

III-2

Risk of bias
Low risk of bias Comments: Please replace this text and include any additional comments in regards to your risk of bias rating

Risk of bias assessment: cohort study

Subject selection
"New technology" group
Representative of eligible patients.
Comparison group
Representative of eligible patients
Comparability of groups on demographic characteristics and clinical features
Comparable
Measurement of outcomes
Outcome measures blind to technology used
No, but objective measures used
Same method of measurement used across comparison groups
Yes
Completeness of follow-up
Was follow-up complete and were all patients included in the analysis?
Yes (follow-up >95%) or survival analysis using all patients
Result of appraisal

Jutta's tick icon.png Included




Completed by

Meghna Kakani


Jutta's tick icon.png This appraisal has been completed.


Article
Berk DR, LaBuz E, Dadras SS, Johnson DL, Swetter SM. Melanoma and melanocytic tumors of uncertain malignant potential in children, adolescents and young adults--the Stanford experience 1995-2008. Pediatr Dermatol 2010 May;27(3):244-54 Available from: http://www.ncbi.nlm.nih.gov/pubmed/20403119.
Assigned to
User:Meghna.kakani
Topic area
Guidelines:Melanoma
Clinical question
Form
Form:Critical appraisal


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