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Melanoma Clinical Staging (Historical and Current)

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Melanoma

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Abstract

Melanoma staging has evolved as our understanding of clinical and pathological risk factors have improved and surgical staging strategies have matured. The current American Joint Committee on Cancer (AJCC) melanoma staging system is based on the tumor (T), node (N), metastasis (M) system, similar to most other solid tumors; criteria that define TNM have changed over time. The T category is determined by primary tumor thickness and presence or absence of ulceration; the N category takes into account both the number of clinically occult and clinically detected lymph node metastases, as well as the presence or absence of non-nodal regional metastases. The M category is defined by anatomic site of disease and lactate dehydrogenase levels. Sentinel lymph node biopsy has become a standard assessment technique by which T2-T4 melanomas, and some T1 melanomas, are staged. Taken together, the melanoma staging system allows for accurate risk stratification of large subsets of melanoma patients that can help guide clinicians and patients regarding prognosis. In the future, melanoma staging may be complemented by validated clinical tools based on multiple clinical, pathological, and molecular risk factors, and may provide a more precise individualized risk assessment for melanoma patients.

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Authors and Affiliations

  1. Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Michael E. Egger

  2. Department of Surgical Oncology, Unit 1484, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey E. Gershenwald

  3. Melanoma and Skin Center, The University of Texas MD Anderson Cancer Center, Houston, TX, USA

    Jeffrey E. Gershenwald

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  1. Michael E. Egger
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  2. Jeffrey E. Gershenwald
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Correspondence to Jeffrey E. Gershenwald .

Editor information

Editors and Affiliations

  1. Harvard/MGH Cutaneous Biology Research C Massachusetts General Hospital, Boston, Massachusetts, USA

    David E. Fisher

  2. Department of Pathology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA

    Boris C. Bastian

Section Editor information

  1. Henri and Belinda Termeer Center for Targeted Therapies, MGH Cancer Center, Boston, MA, USA

    Keith T. Flaherty

  2. UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA, USA

    Boris C. Bastian

  3. Auburndale, MA, USA

    Hensin Tsao

  4. Harvard-MIT Health Sciences and Technology, Cambridge, MA, USA

    Hensin Tsao

  5. Framingham, MA, USA

    F. Stephen Hodi M.D.

  6. Department of Medicine, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Boston, MA, USA

    F. Stephen Hodi M.D.

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Egger, M.E., Gershenwald, J.E. (2018). Melanoma Clinical Staging (Historical and Current). In: Fisher, D., Bastian, B. (eds) Melanoma. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-7322-0_11-1

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