Tas F, Erturk K, et al. - In cutaneous melanoma patients, early relapse and unfavorable survival are significantly independently predicted by higher tumor mitotic rates linked with known histopathological and clinical poor prognostic factors. Survival of melanoma patients with lower and higher mitosis is impacted by different prognostic variables.

• This study involved 970 melanoma patients, with mitotic rates classified as: 0–1, 1.1–4.9, 5–9.9, and ≥10 mitoses/mm ² .

• All cases had 5-year overall survival (OS) rate of 68.7%, it significantly reduced from 87% in melanomas with 0–1 mitoses/mm ² to 65.2%, 56.6%, and 50.4% in melanomas with 1.1–4.9, 5–9.9, and ≥10 mitoses/mm ² , respectively.

• A nodular histology, higher Clark level, thick Breslow depth, ulceration, vertical growth pattern, neurotropism, lymphovascular invasion, de novo melanoma, absence of tumor infiltrating lymphocytes, advanced stage, and relapse are more likely seen with melanomas with higher mitotic rates.

• In 0–1 mitoses/mm ² melanomas, following factors were correlated with OS: age, gender, histology, Clark level, T-stage, ulceration, node involvement, metastasis, and relapse.

• Lymphovascular invasion, BRAF mutation, metastasis, relapse, and relapse pattern hold significance for ≥10 mitoses/mm ² melanomas.