Melanoma maligno

Malignant melanoma

Staging is the process that determines how much cancer is present and where it is located. It describes the severity of a tumor according to the extension of the tumor and possible spread to lymphnodes or other organs. Recognizing the status of the disease allows the physician to formulate a prognosis and to implement the most effective therapy according to the stage of disease

The American Joint Committee on Cancer (AJCC) TNM System

T (describe the tumor, its size and its extension into the skin)

TX   Primary tumor cannot be assessed

T0   No evidence of primary tumor

Tis   Melanoma in situ

T1   Melanoma < 1.0 mm in thickness with or without ulceration

T1a  Melanoma < 1.0 mm in thickness and level II or III, no ulceration

T1b  Melanoma < 1.0 mm in thickness and level IV or V or with          ulceration

T2   Melanoma 1.01-2 mm in thickness with or without ulceration

T2a  Melanoma 1.01-2.0 mm in thickness, no ulceration

T2b  Melanoma 1.01-2.0 mm in thickness, with ulceration

T3    Melanoma 2.01-4 mm in thickness with or without ulceration

T3a  Melanoma 2.01-4.0 mm in thickness, no ulceration

T3b  Melanoma 2.01-4.0 mm in thickness, with ulceration

T4    Melanoma greater than 4.0 mm in thickness with or without         ulceration

T4a  Melanoma > 4.0 mm in thickness, no ulceration

T4b  Melanoma > 4.0 mm in thickness, with ulceration

N (regional lymph nodes)

NX   Regional lymph nodes cannot be assessed

N0   No regional lymph node metastasis

N1   Metastasis in one lymph node

N1a  Clinically occult (microscopic) metastasis

N1b  Clinically apparent (macroscopic) metastasis

N2   Metastasis in two to three regional nodes or intralymphatic regional metastasis without nodal metastases

N2a  Clinically occult (microscopic) metastasis

N2b Clinically apparent (macroscopic) metastasis

N2c  Satelliteor in-transit metastasis without nodal metastasis

N3   Metastasis in four or more regional nodes, or matted metastatic nodes, or in-transit metastasis or satellite(s) with metastasis in regional node(s)

M (distant metastasis)

MX  Distant metastasis cannot be assessed

M0   No distant metastasis

M1   Distant metastasis

M1a  Metastasis to skin, subcutaneous tissues or distant lymph nodes

M1b  Metastasis to lung

M1c  Metastasis to all other visceral sites or distant metastasis at any site associated with an elevated serum lactic dehydrogenase

Staging (SR – survival rate):

Stage 0: Tis, N0, M0: melanoma in situ

Stage IA: T1a, N0, M0: (SR: 99 %)

Stage IB: T1b o T2a, N0, M0: (SR: 92 %)

Stage IIA: T2b o T3a, N0, M0: (SR: 78 %)

Stage IIB: T3b o T4a, N0, M0: (SR: 68%)

Stage IIC: T4b, N0, M0: (SR: 56 %)

Stage IIIA: T1a-4a, N1a o N2a, M0: (SR: not avaible )

Stage IIIb: T1b-4b, N1a o N2a, M0 or T1a-4a, N1b o N2b, M0 or T1a/b-4a/b, N2c, M0: (SR: 50 %)

Stage IIIC: T1b-4b, N1b o N2b, M0 or anyT, N3, M0: (SR: 27 %)

Stage IV: any T, any N, M1: (SR: 18 %)

PDF del “poster on melanoma staging”

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