STAGING  
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AJCC MELANOMA STAGING
Source: J Clin Oncol 2001; 19: 3635-48.   

T

 T0 MELANOMA IN-SITU T0 IN MELANOM STAGING NOT RECOGNIZED
T1 <  1.0 MM T1a WITHOUT ULCERATION AND LEVEL II/III
T1b WITH ULCERATION OR LEVEL IV/V
T2 1.01 – 2.00 MM T2a WITHOUT ULCERATION
T2b WITH ULCERATION
T3 2.01 – 4.00 MM T3a WITHOUT ULCERATION
T3b WITH ULCERATION
T4 > 4.00 MM T4a WITHOUT ULCERATION
T4b WITH ULCERATION

N

 N1 1 NODE N1a MICROMETASTASIS
N1b MACROMETASTASIS
N2 2-3 NODES N2a MICROMETASTASIS1
N2b MACROMETASTASIS2
N2c IN TRANSIT MET(S)/SATELLITE(S) WITHOUT METASTATIC NODES
N3 4 OR MORE METASTATIC NODES, OR MATTED NODES, OR IN TRANSIT MET(S)/SATELLITE(S) WITH METASTATIC NODE(S)    

M

 M1a DISTANT SKIN, SUBCUTANEOUS, OR NODAL METS   SERUM LACTATE DEHYDROGENASE NORMAL
M1b LUNG METASTASES   SERUM LACTATE DEHYDROGENASE NORMAL
M1c ALL OTHER VISCERAL METASTASES

ANY DISTANT METASTASIS

   SERUM LACTATE DEHYDROGENASE NORMAL
  SERUM LACTATE DEHYDROGENASE ELEVATED
1 Micrometastases are diagnosed after sentinel or elective lymphadenectomy.
2 Macrometastases are defined as clinically detectable nodal metastases confirmed by therapeutic lymphadenectomy or when nodal metastasis exhibits gross extracapsular extension.                 

STAGE GROUPING
 

CLINICAL STAGING3

PATHOLOGIC STAGING4
0 Tis N0 M0 Tis N0 M0
IA T1a N0 M0 T1a N0 M0
IB T1b N0 M0 T1b N0 M0
  T2a N0 M0 T2a N0 M0
IIA T2b N0 M0 T2b N0 M0
  T3a N0 M0 T3a N0 M0
IIB T3b N0 M0 T3b N0 M0
  T4a N0 M0 T4a N0 M0
IIC T4b N0 M0 T4b N0 M0
III* Any T N1 M0      
    N2        
    N3        
IIIA       T1-4a N1a M0
        T1-4a N2a M0
IIIB       T1-4b N1a M0
        T1-4b N2a M0
        T1-4a N1b M0
        T1-4a N2b M0
        T1-4a/b N2c M0
IIIC       T1-4b N1b M0
        T1-4b N2b M0
        Any T N3 M0
IV Any T Any N Any M1 Any T Any N Any M1
3 Clinical staging includes microstaging of the primary melanoma and clinical/radiologic evaluation for metastases. By convention, it should be used after complete excision of the primary melanoma with clinical assessment for regional and distant metastases.
 
4 Pathologic staging includes microstaging of the primary melanoma and pathologic information about the regional lymph nodes after partial or complete lymphadenectomy. Pathologic stage 0 or stage 1A patients are the exception; they do not require pathologic evaluation of their lymph nodes.
 
* There are no stage III subgroups for clinical staging.
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