What is the prognosis for a patient with malignant melanoma?
Certain types of melanoma have worse prognoses but this is explained by their thickness. Interestingly, less invasive melanomas even with lymph node metastases carry a better prognosis than deep melanomas without regional metastasis at time of staging. Local recurrences tend to behave similarly to a primary unless they are at the site of a wide local excision (as opposed to a staged excision or punch/shave excision) since these recurrences tend to indicate lymphatic invasion. When melanomas have spread to the lymph nodes, one of the most important factors in determining the patient’s prognosis is the number of nodes with malignancy. In this scenario, sentinel lymph node mapping is done to determine which nodes, if any, have malignancy.
