Prognosis based on melanoma Stage

The prognosis with melanoma depends on a number of factors. It is important to note that whenever you read prognosis information, that it is only a set of statistics. The actual outcome of your case is highly dependent on you, and the things you do to fight the melanoma.

The most common way that doctors determine prognosis is based on the TNM staging system. In August, 2001, a large study was completed and published in the Journal of Clinical Oncology⁽¹⁾ based on the case history of over 17,000 patients, summarizing the outcomes by Stage. The basic statistics are this:

**

5 and 10 Year Survival Rates

Stage	5-year Survival Rate	10-year Survival Rate
Stage 0	100%	100%
Stage I	95-92%	88-79%
Stage II	77-45%	64-32%
Stage III	69-27%	63-18%
Stage IV	19-9%	16-6%

The large ranges of statistics for each stage vary depending on what sub-Stage has been diagnosed.

One important take-away from this chart is that patients who are successful at fighting the melanoma and survive 5-7 years after diagnosis, have a high likelihood of living long lives.

It is very important to note as well that these statistics are assembled for all patients diagnosed at a particular Stage. There are a number of other factors that can significantly affect your outcome at any Stage. For example, the treatment path you follow will have a significant affect on your outcome. Remember that the statistics listed above do not take into consideration whether treatment was used, what treatment was used, and how hard the person fought to survive. If you have been diagnosed with melanoma, in addition to consulting with your doctor, check out the What Can I Do? section of this article to find out many other ways you can fight and survive!

Beyond the factors that are normally considered when determining the Stage of melanoma, a number of other factors can affect your prognosis:

• Age: Younger people tend to have a higher chance of survival. The most significant drop happens after 65- 70 years old. * Sex: Several studies have shown that Women have about a 20% better chance of survival than men⁽²⁾. * LDH:An elevated level of LDH (if measured as elevated two or more times more than 24 hours apart) will tend to suggest a lower chance of survival. A higher LDH level in a patient that has been diagnosed with Stages 1-3 can be a sign that tumors are forming in the body that are not currently detected, and hence they may be at Stage 4. * Race: African Americans tend to have lower survival rates when diagnosed with Melanoma. * Tumor Site: Some studies have shown that melanoma is more serious if it occurs on a foot, palm, in the nail bed of either a finger or toe, on the scalp, back, thorax, upper arm, and throat. ⁽²⁾

• Compromised Immune System: People with low immune function, such as would happen with an HIV infection, tend to have lower survival rates. * Vascularity: If the tumor is more vascular (i.e. it has set up a prominent system of blood vessels) the chances of survival are lower. * Mitotic Rate: A higher mitotic rate means the chances of survival are lower (2)

References:

(1) http://jco.ascopubs.org/ (Study to post: S001 in my file)

(2) Cutaneous Melanoma: Prognostic Factors, Jade Homsi, MD; Mohammed Kashani-Sabet, MD