Melanoma pp 485-500 | Cite as

Melanoma Clinical Staging (Historical and Current)

  • Michael E. Egger
  • Jeffrey E. GershenwaldEmail author
Reference work entry


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.


Melanoma Staging Sentinel lymph node biopsy Prognosis Metastasis Lymphadenectomy Lymph node dissection Risk assessment 


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA
  2. 2.Department of Surgical Oncology, Unit 1484The University of Texas MD Anderson Cancer CenterHoustonUSA
  3. 3.Melanoma and Skin CenterThe University of Texas MD Anderson Cancer CenterHoustonUSA

Section editors and affiliations

  • Keith T. Flaherty
    • 1
  • Boris C. Bastian
    • 2
  • Hensin Tsao
    • 3
    • 4
  • F. Stephen Hodi
    • 5
    • 6
  1. 1.Henri and Belinda Termeer Center for Targeted TherapiesMGH Cancer CenterBostonUSA
  2. 2.UCSF Helen Diller Family Comprehensive Cancer CenterSan FranciscoUSA
  3. 3.AuburndaleUSA
  4. 4.Harvard-MIT Health Sciences and TechnologyCambridgeUSA
  5. 5.FraminghamUSA
  6. 6.Department of Medicine, Brigham and Women's HospitalDana-Farber Cancer InstituteBostonUSA

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