Melanoma staging: Evidence‐based changes in the American Joint Committee on Cancer eighth edition cancer staging manual. (13th October 2017)

• Record Type: Journal Article
• Authors: Gershenwald, Jeffrey E.; Scolyer, Richard A.; Hess, Kenneth R.; Sondak, Vernon K.; Long, Georgina V.; Ross, Merrick I.; Lazar, Alexander J.; Faries, Mark B.; Kirkwood, John M.; McArthur, Grant A.; Haydu, Lauren E.; Eggermont, Alexander M. M.; Flaherty, Keith T.; Balch, Charles M.; Thompson, John F.
• Other Names: Gershenwald Jeffrey E. investigator.; Scolyer Richard A. investigator.; Atkins Michael B. investigator.; Balch Charles M. investigator.; Barnhill Raymond L. investigator.; Bilimoria Karl Y. investigator.; Buzaid Antonio C. investigator.; Byrd David R. investigator.; Cochran Alistair J. investigator.; Eggermont Alexander M. M. investigator.; Elder David E. investigator.; Faries Mark B. investigator.; Flaherty Keith T. investigator.; Garbe Claus investigator.; Gardner Julie M. investigator.; Gimotty Phyllis A. investigator.; Halpern Allan C. investigator.; Haydu Lauren E. investigator.; Hess Kenneth R. investigator.; Johnson Timothy M. investigator.; Kirkwood John M. investigator.; Lazar Alexander J. investigator.; Lee Anne W. M. investigator.; Long Georgina V. investigator.; McArthur Grant A. investigator.; Mihm Jr Martin C. investigator.; Prieto Victor G. investigator.; Ross Merrick I. investigator.; Sober Arthur J. investigator.; Sondak Vernon K. investigator.; Thompson John F. investigator.; Wong Sandra L. investigator.; Delman Keith A. investigator.; Santinami Mario investigator.; Maurichi Andrea investigator.; Nagore Eduardo investigator.; Faries Mark B. investigator.; Thompson John F. investigator.; Scolyer Richard A. investigator.; McArthur Grant A. investigator.; Gyorki David E. investigator.; Henderson Michael investigator.; Stratigos Alexander J. investigator.; Gogas Helen investigator.; Gershenwald Jeffrey E. investigator.; Haydu Lauren E. investigator.; Rossi Carlo Riccardo investigator.; Sommariva Antonio investigator.;
• Is Part Of: CA. Volume 67:Number 6(2017:Nov./Dec.)
• Page Start: 472
• Page End: 492
• Publication Date: 2017-10-13
• Subjects: American Joint Committee on Cancer (AJCC) -- melanoma -- metastasis -- pathology -- prognosis -- staging -- survival -- TNM classification; Cancer -- Periodicals; Neoplasms -- Periodicals; Neoplasms; 616.99405
• DOI: 10.3322/caac.21409
• Languages: English
• ISSNs: 0007-9235

Abstract

Abstract: Answer questions and earn CME/CNE To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46, 000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, <0.8 mm without ulceration; T1b, 0.8‐1.0 mm with or without ulceration or <0.8 mm with ulceration), with mitotic rate no longer a T category criterion; 3) pathological (but not clinical) stage IA is revised to include T1b N0 M0 (formerly pathologic stage IB); 4) the N category descriptors "microscopic" and "macroscopic" for regional node metastasis are redefined as "clinically occult" and "clinically apparent"; 5) prognostic stage III groupings are based on N category criteria and T category criteria (ie, primary tumor thickness and ulceration) and increased from 3 to 4 subgroups (stages IIIA‐IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or in‐transit metastases now categorized as N1c, N2c, or N3c based on the number of tumor‐involved regional lymph nodes, if any; 7) descriptors are added to each M1 subcategory designation for lactate dehydrogenase (LDH) level (LDH elevation no longer upstages to M1c); and 8) a new M1d designation is added for central nervous system metastases. This evidence‐based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials.CA Cancer J Clin 2017;67:472‐492. ©2017 American Cancer Society.