© 2000 by Oxford University Press
Journal of the National Cancer Institute, Vol. 92, No. 17, 1370,
September 6, 2000
© 2000 Oxford University Press
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New Melanoma Staging System
The new melanoma staging system from the American Joint Committee on Cancer is the "most significant revision in decades," said Charles Balch, M.D., vice president of the American Society of Clinical Oncology and chairman of the staging committee. Among the major changes: 1) tumor thickness has replaced level of invasion as a criterion, 2) number of lymph nodes has replaced size, and 3) ulceration of the primary tumor results in upstaging for each subgroup. The system also defines different subgroups depending on whether the nodes were clinically or pathologically staged, as follows:• CLINICAL STAGING
IIIA – Any size tumor with one involved lymph node
IIIB – Any size tumor with multiple involved lymph nodes
IIIC – Any size tumor with satellite or in-transit nodal metastases
• PATHOLOGIC STAGING
IIIA – Any size tumor that is not ulcerated, with 1–3 nodal micrometastases
IIIB – Any size tumor that is ulcerated, with 1–3 nodal micrometastases
Any size tumor that is not ulcerated, with 1–3 clinically detectable nodes
Any size tumor, ulcerated or not, with satellite or in-transit metastases
IIIC – Any size tumor that is ulcerated, with 1–3 clinically detectable nodes
Any size tumor, ulcerated or not, with 4 or more metastatic nodes
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