Staging Criteria for Malignant Melanoma

1 Tumor cells are confined to the epidermis.

2 Tumor cells penetrate the papillary dermis.

3 Tumor cells accumulate between papillary and reticular dermis.

4 Tumor cells extend between collagen bundles of the reticular dermis.

5 Tumor cells invade the subcutaneous tissue.

TNM Staging System

This system correlates tumor size (T), nodal involvement (N), and metastatic progress (M).

T Primary Tumor

T0 Tumor confined to epidermis (Clark level 1).

T1 Tumor invades papillary dermis (level 2), or tumor is 0.75 mm thickness or less.

T2 Tumor extends to the interface between the papillary and reticular dermis (level 3), or tumor is 0.76 – 1.5 mm thickness.

T3 Tumor extends into reticular epidermis (level 4), or tumor is 1.51- 4.0 mm thickness.

T4 Tumor invades subcutaneous tissue (level 5), or tumor is 4.1 mm or more thickness, or satellite site within 2 cm of primary melanoma.

N Nodal Involvement

N0 No evidence of regional lymph node involvement.

N1 Movable nodes, 5 cm or less in dia. Involving one regional node station, or no regional lymph node involvement and the presence of less than five in-transit metastasis beyond 2.0 cm from primary site.

N2 Involvement of more than one regional lymph node station, or regional nodes more than 5.0 cm. In dia., or any in-transit metastasis beyond 2 cm. from the primary site with regional lymph node involvement.

M Distant Metastasis

M0 No evidence of metastasis.

M1 Metastasis to skin or subcutaneous tissue beyond the site of primary lymph drainage.

M2 Metastasis to any distant site other than skin or subcutaneous tissue.
 

Melanoma