Article

Final version of the American Joint Committee on Cancer staging system for cutaneous melanoma.

Johns Hopkins Medical Institutions, Baltimore, MD, USA.
Journal of Clinical Oncology (impact factor: 18.37). 09/2001; 19(16):3635-48. pp.3635-48
Source: PubMed

ABSTRACT To revise the staging system for cutaneous melanoma under the auspices of the American Joint Committee on Cancer (AJCC).
The prognostic factors analysis described in the companion publication (this issue), as well as evidence from the published literature, was used to assemble the tumor-node-metastasis criteria and stage grouping for the melanoma staging system.
Major changes include (1) melanoma thickness and ulceration but not level of invasion to be used in the T category (except for T1 melanomas); (2) the number of metastatic lymph nodes rather than their gross dimensions and the delineation of clinically occult (ie, microscopic) versus clinically apparent (ie, macroscopic) nodal metastases to be used in the N category; (3) the site of distant metastases and the presence of elevated serum lactic dehydrogenase to be used in the M category; (4) an upstaging of all patients with stage I, II, and III disease when a primary melanoma is ulcerated; (5) a merging of satellite metastases around a primary melanoma and in-transit metastases into a single staging entity that is grouped into stage III disease; and (6) a new convention for defining clinical and pathologic staging so as to take into account the staging information gained from intraoperative lymphatic mapping and sentinel node biopsy.
This revision will become official with publication of the sixth edition of the AJCC Cancer Staging Manual in the year 2002.

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Keywords

AJCC Cancer Staging Manual
 
American Joint Committee
 
companion publication
 
cutaneous melanoma
 
defining clinical
 
distant metastases
 
gross dimensions
 
III disease
 
in-transit metastases
 
intraoperative lymphatic
 
metastatic lymph nodes
 
primary melanoma
 
prognostic factors analysis
 
satellite metastases
 
sentinel node biopsy
 
serum lactic dehydrogenase
 
stage III disease
 
staging information
 
staging system
 
T1 melanomas