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 malignant melanoma depends upon: March 2011, March 2013 
Select and explain. 
A. Grade of tumour, B. Age of the patient, C. Invasion of nearby nodes, D. Site of lesion
C: Invasion of nearby nodes
Answer: C: Invasion of nearby nodes 
Explanation: Ans. C: Invasion of nearby nodes The presence of lymph node metastases is the single most impoant prognostic index in melanoma, outweighing both tumour and host factors Melanoma: May be familial Originate from melanocytes Cutaneous melanoma arises from epidermal melanocytes Spread by the lymphatic channels or the bloodstream Lentigo maligna (least common) involves face commonly Superficial spreading is the MC type Nodular melanoma is the most malignant type