Melanoma staging: Difference between revisions
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Sergekorjian (talk | contribs) /* Distant Metastasis (M){{cite journal| author=Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR et al.| title=Final version of 2009 AJCC melanoma staging and classification. | journal=J Clin Oncol | year= 2009 | volume= 27 | issue=... |
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Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion. | ====Clark Level<ref name="pmid2593166">{{cite journal| author=Clark WH, Elder DE, Guerry D, Braitman LE, Trock BJ, Schultz D et al.| title=Model predicting survival in stage I melanoma based on tumor progression. | journal=J Natl Cancer Inst | year= 1989 | volume= 81 | issue= 24 | pages= 1893-904 | pmid=2593166 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2593166 }} </ref>==== | ||
{| {{table}} | |||
! style="background: #4479BA;" | {{fontcolor|#FFF|'''Clark Level'''}} | |||
! style="background: #4479BA;" | {{fontcolor|#FFF|'''Definition'''}} | |||
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| Level I||Above the basement membrane | |||
|- | |||
| Level II||Infiltrating the papillary dermis | |||
|- | |||
| Level III||Between papillary dermis and reticular dermis | |||
|- | |||
| Level IV||Infiltrating the reticular dermis | |||
|- | |||
| Level V||Infiltrating subcutaneous tissue | |||
|} | |||
Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion. | |||
===Staging of Melanoma=== | ===Staging of Melanoma=== | ||
Revision as of 21:22, 21 August 2015
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Melanoma Microchapters |
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Diagnosis |
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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 of melanoma is essential to determine the prognosis. Staging is based on the 2010 AJCC TNM Classification and is divided into stage 0 or melanoma in situ, stage 1 or invasive melanoma with good prognosis, stage 2 or high risk melanoma, stage 3 or melanoma with regional lymph node metastasis, and stage 4 or melanoma with distant metastasis.
Staging
2010 American Joint Committee on Cancer (AJC) TNM Definitions for Melanoma
Primary Tumor (T)[1]
| 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)[1]
| 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)[1]
| 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 |
Clark Level[2]
| Clark Level | Definition |
|---|---|
| Level I | Above the basement membrane |
| Level II | Infiltrating the papillary dermis |
| Level III | Between papillary dermis and reticular dermis |
| Level IV | Infiltrating the reticular dermis |
| Level V | Infiltrating subcutaneous tissue |
Also of importance are the "Clark level" and "Breslow depth" which refer to the microscopic depth of tumor invasion.
Staging of Melanoma
Stage 0: Melanoma in Situ, 100% Survival
- Tis (Clark Level I)
Stage I: Invasive Melanoma, 85-95% Survival
- T1a (Clark Level II-III)
- T1b (Clark Level IV-V)
- T2a
Stage II: High Risk Melanoma, 40-85% Survival
- T2b
- T3a
- T3b
- T4a
- T4b
Stage III: Regional Metastasis, 25-60% Survival
- N1
- N2
- N3
Stage IV: Distant Metastasis, 9-15% Survival
- M1a
- M1b
- M1c
References
- ↑ 1.0 1.1 1.2 Balch CM, Gershenwald JE, Soong SJ, Thompson JF, Atkins MB, Byrd DR; et al. (2009). "Final version of 2009 AJCC melanoma staging and classification". J Clin Oncol. 27 (36): 6199–206. doi:10.1200/JCO.2009.23.4799. PMC 2793035. PMID 19917835.
- ↑ Clark WH, Elder DE, Guerry D, Braitman LE, Trock BJ, Schultz D; et al. (1989). "Model predicting survival in stage I melanoma based on tumor progression". J Natl Cancer Inst. 81 (24): 1893–904. PMID 2593166.