Malignant melanoma of the skin: Prognostic value of histology in 89 cases

Abstract

A detailed histological study of 89 malignant melanomas with an assessment of the relationship of 14 histological features to 5 year survival is reported. (1) Depth of spread (related to sweat glands) shows a significant relationship. Deep spread is associated with poor survival. (2) Mitotic count is of borderline significance. High mitotic count, >1 mitosis/5 high power fields, signifies a poor prognosis. (3) 1 and 2 show an over-riding influence on survival compared to all other features. It was nevertheless noted in this series that: 459 (a) Polypoid shape in deep, high mitotic grade tumours is associated with slightly improved survival. (b) Well marked epidermal hyperplasia in deep, high mitotic grade tumours decreased survival to nil. (4) A preponderence of spindle malignant cells in high mitotic grade lesions is significantly associated with improved survival. In superficial lesions such an association is marginal. (5) The presence and degree of pigmentation, ulceration, round cell infiltration, naevoid pattern, giant cells, epithelial malignant cells and vessel invasion tend to be associated with a poorer prognosis. (6) Junctional activity and absence of hair were always found and are not analysed as they are considered to be essential diagnostic criteria of malignant melanomas. © 1968, The British Empire Cancer Campaign for Research. All rights reserved.