Melanoma staging: Difference between revisions
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===2010 American Joint Committee on Cancer (AJC) TNM Definitions for Melanoma=== | ===2010 American Joint Committee on Cancer (AJC) TNM Definitions for Melanoma=== | ||
====Primary Tumor (T)==== | ====Primary Tumor (T)==== | ||
{| {{table}} | {| {{table}} | ||
| align="center" style="background:#f0f0f0;"|'''T Classification''' | | align="center" style="background:#f0f0f0;"|'''T Classification''' | ||
| Line 14: | Line 13: | ||
| align="center" style="background:#f0f0f0;"|'''Ulceration status/mitoses''' | | align="center" style="background:#f0f0f0;"|'''Ulceration status/mitoses''' | ||
|- | |- | ||
| | | TX||Primary tumor cannot be assessed|| | ||
|- | |||
| T0||No evidence of primary tumor|| | |||
|- | |||
| Tis|| Melanoma in situ|| | |||
|- | |- | ||
| T1b||≤ 1.0 mm||Ulcerated or ≥1 mitosis/mm2 | | T1b||≤ 1.0 mm||Ulcerated or ≥1 mitosis/mm2 | ||
| Line 29: | Line 32: | ||
|- | |- | ||
| T4b||> 4.0 mm||Ulcerated | | T4b||> 4.0 mm||Ulcerated | ||
|} | |||
====Regional Lymph Nodes (N)==== | |||
{| {{table}} | |||
| align="center" style="background:#f0f0f0;"|'''N Classification''' | |||
| align="center" style="background:#f0f0f0;"|'''Number of Nodes''' | |||
| align="center" style="background:#f0f0f0;"|'''Nodal Mass''' | |||
|- | |||
| NX||Lymph node metastasis cannot be assessed|| | |||
|- | |||
| N0||No lymph node metastasis|| | |||
|- | |||
| N1a||1 node||Micrometastasis | |||
|- | |||
| N1b||1 node||Macrometastasis | |||
|- | |||
| N2a||2 - 3 nodes||Micrometastasis | |||
|- | |||
| N2b||2 - 3 nodes||Macrometastasis | |||
|- | |||
| N2c||2 - 3 nodes||In-transit metastasis/Satellites without metastatic nodes | |||
|- | |||
| N3||≥ 4 nodes||Metastatic nodes, Matted nodes, In-transit metastasis/Satellites with metastatic nodes | |||
|} | |} | ||
====Distant Metastasis (M)==== | |||
{| {{table}} | |||
| align="center" style="background:#f0f0f0;"|'''M Classification''' | |||
| align="center" style="background:#f0f0f0;"|'''Definition''' | |||
|- | |||
| M0||No evidence of distant metastasis | |||
|- | |||
| M1a||Metastasis to skin, subcutaneous tissue, or distant lymph nodes | |||
|- | |||
| M1b||Metasitasis to lung | |||
|- | |||
| M1c||Metastasis to any other visceral site with elevated LDH | |||
|} | |||
Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion.<ref> [http://chorus.rad.mcw.edu/doc/00955.html Malignant melanoma: staging] at Collaborative Hypertext of Radiology</ref> | Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion.<ref> [http://chorus.rad.mcw.edu/doc/00955.html Malignant melanoma: staging] at Collaborative Hypertext of Radiology</ref> | ||
Revision as of 20:58, 21 August 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Melanoma Microchapters |
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Treatment |
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Case Studies |
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Melanoma staging On the Web |
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American Roentgen Ray Society Images of Melanoma staging |
Overview
Staging
2010 American Joint Committee on Cancer (AJC) TNM Definitions for Melanoma
Primary Tumor (T)
| T Classification | Thickness | Ulceration status/mitoses |
| TX | Primary tumor cannot be assessed | |
| T0 | No evidence of primary tumor | |
| Tis | Melanoma in situ | |
| T1b | ≤ 1.0 mm | Ulcerated or ≥1 mitosis/mm2 |
| T2a | 1.01 - 2.0 mm | No ulceration |
| T2b | 1.01 - 2.0 mm | Ulcerated |
| T3a | 2.01 - 4.0 mm | No ulceration |
| T3b | 2.01 - 4.0 mm | Ulcerated |
| T4a | > 4.0 mm | No ulceration |
| T4b | > 4.0 mm | Ulcerated |
Regional Lymph Nodes (N)
| N Classification | Number of Nodes | Nodal Mass |
| NX | Lymph node metastasis cannot be assessed | |
| N0 | No lymph node metastasis | |
| N1a | 1 node | Micrometastasis |
| N1b | 1 node | Macrometastasis |
| N2a | 2 - 3 nodes | Micrometastasis |
| N2b | 2 - 3 nodes | Macrometastasis |
| N2c | 2 - 3 nodes | In-transit metastasis/Satellites without metastatic nodes |
| N3 | ≥ 4 nodes | Metastatic nodes, Matted nodes, In-transit metastasis/Satellites with metastatic nodes |
Distant Metastasis (M)
| M Classification | Definition |
| M0 | No evidence of distant metastasis |
| M1a | Metastasis to skin, subcutaneous tissue, or distant lymph nodes |
| M1b | Metasitasis to lung |
| M1c | Metastasis to any other visceral site with elevated LDH |
Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion.[1]
Staging of Melanoma
Stage 0: Melanoma in Situ (Clark Level I), 100% Survival
Stage I/II: Invasive Melanoma, 85-95% Survival
- T1a: Less than 1.00 mm primary, w/o Ulceration, Clark Level II-III
- T1b: Less than 1.00 mm primary, w/Ulceration or Clark Level IV-V
- T2a: 1.00-2.00 mm primary, w/o Ulceration
Stage II: High Risk Melanoma, 40-85% Survival
- T2b: 1.00-2.00 mm primary, w/ Ulceration
- T3a: 2.00-4.00 mm primary, w/o Ulceration
- T3b: 2.00-4.00 mm primary, w/ Ulceration
- T4a: 4.00 mm or greater primary w/o Ulceration
- T4b: 4.00 mm or greater primary w/ Ulceration
Stage III: Regional Metastasis, 25-60% Survival
- N1: Single Positive Lymph Node
- N2: 2-3 Positive Lymph Nodes OR Regional Skin/In-Transit Metastasis
- N3: 4 Positive Lymph Nodes OR Lymph Node and Regional Skin/In Transit Metastases
Stage IV: Distant Metastasis, 9-15% Survival
- M1a: Distant Skin Metastasis, Normal LDH
- M1b: Lung Metastasis, Normal LDH
- M1c: Other Distant Metastasis OR Any Distant Metastasis with Elevated LDH
Based Upon AJCC 5-Year Survival With Proper Treatment
References
- ↑ Malignant melanoma: staging at Collaborative Hypertext of Radiology