According to an article by Schmoeckel and Braun-Falco (Arch Dermatol 114:871-873, 1978), the best method of predicting metastases from malignant melanoma was the prognostic index, which was defined as the product of tumor thickness (millimeter) and the number of mitoses per square millimeter. This index allowed the authors to predict with a high degree of accuracy those primary melanomas that later developed metastases. This potentially important observation has the great advantage of simplicity for the pathologist since all it requires is the determination of two values—tumor thickness and mitoses per square millimeter. However, it is likely that numerous factors will eventually be found to have added importance in prognosticating the outcome of primary malignant melanomas.
Thus, factors such as type of melanoma (lentigo maligna melanoma, superficial spreading melanoma, nodular melanoma, acral lentiginous melanoma, and mucosal melanomas), the site of the melanoma (head and neck, trunk, limbs, palms and soles, and
Kopf AW. The Prognostic Index in Malignant Melanoma. JAMA. 1978;239(25):2695. doi:10.1001/jama.1978.03280520067026
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