I received many questions regarding melanoma and its prognostic factors so I summarised most of the important ones below and have given a brief, general description for each.
AGE – the older the patient, the poorer the prognosis.
SEX – generally females have a better prognosis than males.
BODY SITE – melanomas on the extremities (eg. legs and arms) have a better prognosis than those on the neck, trunk and face.
INVOLVEMENT OF LYMPH NODES – presence of tumour lymph node involvement has a poorer prognosis. Generally the more nodes involved the poorer the prognosis.
TUMOUR THICKNESS – the thicker the melanoma the poorer the prognosis.
ULCERATION – the presence of ulceration indicates a poorer prognosis.
MITOTIC RATE – the higher the mitotic rate the poorer the prognosis.
REGRESSION – presence of regression in thin melanomas indicates a poorer prognosis.
There are a few other prognostic factors such as Clarks level, tumour-infiltrating lymphocytes, BRAF mutations and LDH (lactate dehydrogenase) serum level.
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