The American Joint Committee on
Cancer has developed a system for classifying cancers according to the extent
of the cancer. Complete excision of the melanoma is followed by assessment of
lymph nodes and other parts of the body to determine whether the cancer has
spread. The staging system looks at other factors that have been found to
affect survival, such as tumor thickness (Breslow level), depth of invasion
(Clark level), and
Two systems are used for staging melanoma.
The clinical staging system uses the letter T to describe
primary tumors, the letter N to describe lymph node involvement, and the letter
M for metastases (spread). Numbers after each of these letters show the
seriousness of the disease.
Tumor (describes the primary
Nodes (describes whether cancer has
spread into the lymph nodes)
Metastasis (describes the extent of
cancer spread outside primary melanoma site)
The pathologic staging system uses all the above information
and adds the pathologic evaluation of the lymph nodes and the examination of
any evidence of melanoma spread.
Tis, N0, M0
T1a, N0, M0
T1b, N0, M0
T2a, N0, M0
T2b, N0, M0
T3a, N0, M0
T3b, N0, M0
T4a, N0, M0
T4b, N0, M0
T1–4a, N1a, M0
T1–4a, N2a, M0
T1–4b, N1a, M0
T1–4b, N2a, M0
T1–4a, N1b, M0
T1–4a, N2b, M0
T1–4a, N2c, M0
T1–4b, N1b, M0
T1–4b, N2b, M0
T1–4b, N2c, M0
Any T, N3, M0
Any T, Any N, M1
CitationsAmerican Joint Committee on Cancer (2010). Melanoma of the skin. In AJCC Cancer Staging Manual, 7th ed., pp. 325–344. New York: Springer.
December 17, 2010
Kathleen Romito, MD - Family Medicine & Alexander H. Murray, MD, FRCPC - Dermatology
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