This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
Prognosis of melanoma depends ona) Stageb) Depth of melanoma of biopsyc) Duration of growthd) Site 
Select and explain. 
A. acd, B. bcd, C. abd, D. ab
C: abd
Answer: C: abd 
Explanation: Prognosis of melanoma depends most importantly on staging. The most current staging system (of AJCC) takes into account following factors


depth of invasion (Breslow's thickness) - this is the single most important prognostic factor
ulceration - presence of ulceration carries worse prognosis.
lymph node status
satellite lession
distant metastasis

Other prognostic factor (not included in staging)

Site or anatomic location - people with lesion of the extermities have a better prognosis than people with melanomas of the head & neck or trunk. (feet and mucous membrane also have poor prognosis- Harrison)
Gender -females have better prognosis than males
Histologic type - Lentigo maligna has best prosnosis & acral lentiginous worst.
Old age especially > 60 have poorer prognosis.

Also know
The factor that most closely correlates with local recurrence is primary tumor ulceration (Sabiston 18/e p774)