The Immune Recovery Clinic of the Immune Recovery Foundation
Staging Criteria for Malignant Melanoma:
Clark Level from Biopsy
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.