Prognosis and survival for melanoma skin cancer

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A prognosis is the doctor's best estimate of how cancer will affect you and how it will respond to treatment. Survival is the percentage of people with a disease who are alive at some point in time after their diagnosis. Prognosis and survival depend on many factors.

The doctor will look at certain aspects of the cancer as well as characteristics of the person (such as their age or sex). These are called prognostic factors. The doctor will also look at predictive factors, which influence how a cancer will respond to a certain treatment and how likely it is that the cancer will come back after treatment.

Prognostic and predictive factors are often discussed together. They both play a part in deciding on a prognosis and a treatment plan just for you. Only a doctor familiar with your medical history, the type and stage and other features of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis and chances of survival.

The following are prognostic and predictive factors for melanoma skin cancer.

Thickness of the tumour

The thickness of the primary tumour refers to how many layers of skin it has grown into. It is an important prognostic factor because it helps predict the risk that the cancer will spread. Thicker tumours have a higher risk of spreading to other parts of the body and coming back (recurring) after treatment. The thicker the tumour, the poorer the prognosis.


Ulceration is when melanoma has grown through the top layer of the skin (called the epidermis) and causes an open wound. Sometimes ulcerated tumours bleed. In other cases, ulceration can only be seen when the tumour is viewed under a microscope.

An ulcerated primary tumour has a less favourable prognosis than one that isn't ulcerated. Ulceration increases the risk that the cancer will spread to other parts of the body and come back after treatment.

Mitotic rate

Mitotic rate measures how fast cancer cells are dividing and growing. It is the number of cells that divide (mitosis) in a certain amount or area of cancer tissue. An increased mitotic rate is linked with a poor prognosis.

Lymph nodes with cancer

If cancer has spread to nearby lymph nodes, the prognosis is poorer. The more lymph nodes that contain cancer, the poorer the prognosis.

Location of cancer on the skin

Having melanoma on the arms or legs (extremities) has a better prognosis than having melanoma on the central part of the body (trunk), head or neck. Melanoma on the palms of the hands or soles of the feet also has a poorer prognosis compared to other locations.


Women tend to have a better prognosis than men when diagnosed with melanoma. This may be because women more commonly develop melanomas on the arms and legs, while men more commonly develop melanomas that involve the trunk, head or neck.

We need more research and can't say at this time what the prognosis is for transgender, non-binary and gender-diverse people.


People younger than 35 years of age have a greater risk of melanoma spreading to nearby lymph nodes. But, overall, people who are older have a poorer prognosis.

Growth pattern

Nodular melanoma has a poor prognosis because it grows down into the layers of the skin (vertical growth pattern) and tends to be thick when diagnosed.

Distant metastases

Melanoma has a poor prognosis when it spreads to other parts of the body (called distant metastases), such as the lung, the liver or the brain.

For metastatic melanoma, a high lactate dehydrogenase (LDH) level in the blood has a poorer prognosis than when the LDH level is normal.

Expert review and references

  • Frances Wright, MD, FRCSC
  • Gershenwald JE, Scolyer RA, Hess KR et al . Melanoma of the skin. Amin, MB (ed.). AJCC Cancer Staging Manual. 8th ed. Chicago, IL: American College of Surgeons; 2017: 47:563–586.
  • National Comprehensive Cancer Network . NCCN Clinical Practice Guidelines in Oncology: Cutaneous Melanoma (Version 2.2023). 2023.
  • PDQ Adult Treatment Editorial Board. Melanoma Treatment (PDQ®) – Health Professional Version. Bethesda, MD: National Cancer Institute; 2023:
  • Ribas A, Ariyan CE, Barker CA. Cutaneous melanoma. DeVita VT Jr, Lawrence TS, Rosenberg S. eds. DeVita Hellman and Rosenberg's Cancer: Principles and Practice of Oncology. 12th ed. Philadelphia, PA: Wolters Kluwer; 2023: Kindle version, chapter 63,
  • Tan WW. Medscape Reference: Malignant Melanoma. 2023:

Survival statistics for melanoma skin cancer

Survival statistics for melanoma skin cancer are very general estimates. Survival is different for each stage.

Medical disclaimer

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