Prognosis and predictive factors

PLMMM has a poor prognosis. The average survival rate is usually less than 3.5 years {2159,2754} with a 5-year survival rate of less than 20% {2754}. Radical surgical excision is the treatment of choice. Adjuvant radiotherapy and chemotherapy are of questionable value in the management of PLMMM. Approximately 80% of patients with PLMMM have metastatic disease to the regional lymph nodes as well as to distant viscera (e.g., brain, lungs, bone). Pathologic criteria that are used to predict the biologic behaviour in association with cutaneous melanomas, including the depth of invasion, age and gender of the patient, and cytomorpholo-gy generally do not apply for PLMMM {2754,2755}. Further, prognostic significance has not been found for tumour thickness, level of invasion, ulceration, mitotic index or nerve/nerve sheath involvement for PLMMM {2080}.

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Fig. 3.71 Primary laryngeal mucosal malignant melanoma. Immunohistochemical reactivity in this epithelioid melanoma includes: A HMB-4 B S100 protein. C melan A and D vimentin.

Fig. 3.71 Primary laryngeal mucosal malignant melanoma. Immunohistochemical reactivity in this epithelioid melanoma includes: A HMB-4 B S100 protein. C melan A and D vimentin.

Primary laryngeal mucosal malignant melanoma 161

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