Blakely A, et al. - Given an association of thick melanomas, defined as ≥ 4 mm in thickness, with poor overall survival (OS) and of ultrathick melanomas, lesions ≥ 8 mm in thickness, with worse survival, researchers sought for prognostic factors for thick and ultrathick melanoma. A prospective database of patients receiving an operation for melanoma, from June 2005 to December 2016, yielded data of 95 patients with thick melanoma; of these, 37 (39%) had ultrathick tumors. The analysis revealed a higher disease progression in the ultrathick melanoma group. They observed decreased progression-free survival in association with thicker tumors, head/neck location, and positive lymph nodes. Decreased OS was evident in association with high neutrophil to lymphocyte ratio. Ultrathick melanomas represent advanced malignancy; however, surgical treatment may assist in achieving locoregional control in these patients.