Most impoant prognostic factor in melanoma
High-Yield Explanation
The presence of lymph node metastases is the single most impoant prognostic index in melanoma, outweighing both tumour and host factors. The number of affected nodes and the presence of extranodal extension are also significant outcome predictors. Once regional nodes are clinically involved, 70-85% of patients will have occult distant metastases.The Breslow thickness of the primary tumour offers the best correlation with survival in stage I disease. The higher the mitotic index, the poorer is the prognosis of the primary tumour. This has greater significance than the presence or absence of ulceration.Ref: Bailey and Love, 27e, page: 612