Prognosis and predictive factors

The prognosis for oral melanoma is poor with an overall median survival of about 2 years and 5-year survival of less than 20% {122,170,1085}. Stage is a predictor of survival but even localized tumours (stage I) show a 5-year survival of less than 50%. Depth of invasion (Breslow thickness and Clark's levels) is of limited value in oral lesions. This is due to lack of adequate studies and the fact that most oral melanomas are deeper than 4 mm at presentation {1085,1843,2080}.

Nevertheless, lesions thicker than 5 mm may have a significantly worse prognosis. Other factors associated with poor prognosis include, vascular invasion, necrosis, a polymorphous tumour cell population, and increasing age {170,1085,1843,2080}.

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