Prognostic factors in primary cutaneous melanoma.

Tumor thickness has historically been the single most important factor in risk assessment for stage I and II melanoma patients. However, it is possible to more accurately determine a patient's prognosis by also using other known prognostic indicators, such as ulceration, vascular invasion, and angiogenesis. A probabilistic approach to risk assessment has implications for the appropriate selection of treatment modalities, such as sentinel lymph node biopsy and re-excision margins. Each patient's risk for recurrence also has implications for which follow-up protocol would be most appropriate for the patient. Finally, those risk factors that repeatedly demonstrate an independent impact on prognosis should be used as stratification factors in adjuvant therapy trials.