Guidelines of prognostics in malignant skin melanoma

The author gives a survey of relevant literary data and own experience on the prognostication of melanoma. The patients studied between 1967-1985 July consisted of 165 cases, 5 of them presenting with unknown primary diseases and 19 cases unfit for evaluation. Great attention was paid to the clinical presentation of stage I melanomas, where early and late signs of malignant transformation constitute separate items in order to alleviate early diagnosis and adequate treatment. Distinction between early and late signs was supported also by histological findings. A regression analysis of the two main prognosticators 'thickness' and 'level of invasion' yielded a 80% correlation in favour of the microstaging by invasion levels. The overall survival of 47 patients with exulcerated lesions compared to a total database of 118 cases did not reach but 37 months according to an earlier study from 1981. Scrutiny and meticulous investigation are stressed for sake of diagnostic accuracy which may be increased above 80% as reported on the basis of own experience.