Merkel cell cancer staging
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]
Overview
The staging of Merkel cell cancer is based on the TNM staging system.
Staging
- According to the TNM staging system, merkel cell cancer is classified into 4 stages based on the following:
- Tumor size
- Involvement of lymph nodes, and
- Metastasis
- The stages of Merkel cell carcinoma are shown in the table below:
Stage | Primary Tumor (T) | Lymph Node (N) | Metastasis (M) |
0 | In situ | No regional lymph node metastasis | No distant metastasis |
IA | ≤2 cm | Nodes negative by pathologic exam | No distant metastasis |
IB | ≤2 cm | Nodes negative by clinical exam (no pathologic node exam performed) | No distant metastasis |
IIA | >2 cm | Nodes negative by pathologic exam | No distant metastasis |
IIB | >2 cm | Nodes negative by clinical exam (no pathologic node exam performed) | No distant metastasis |
IIC | Invades bone, muscle and cartilage | No regional lymph node metastasis detected | No distant metastasis |
IIIA | Any size tumor (includes invading tumors) | Micrometastasis (diagnosed after sentinel or elective lymphadenectomy) | No distant metastasis |
IIIB | Any size tumor (includes invading tumors) | Postive for:
|
No distant metastasis |
IV | Any size tumor (includes invading tumors) | Any lymph node metastasis | Metastasis beyond regional lymph nodes |
Adapted from the American Joint Committee on Cancer (AJCC) - 2009