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TNM and Stage Groupings > Melanoma of the Skin
Melanoma of the Skin
Primary Tumor (T)
| T Category |
Stage Category Definitions |
| TX |
Primary tumor cannot be assessed |
| T0 |
No evidence of primary tumor |
| Tis |
Melanoma in situ |
| T1 |
Melanomas ≦ 1.0 mm in thickness |
| T1a |
without ulceration and mitosis < 1/mm2 |
| T1b |
with ulceration or mitoses > 1/mm2 |
| T2 |
Melanomas 1.01 - 2.0 mm |
| T2a |
without ulceration |
| T2b |
with ulceration |
| T3 |
Melanomas 2.01 - 4.0 mm |
| T3a |
without ulceration |
| T3b |
with ulceration |
| T4 |
Melanomas > 4.0 mm |
| T4a |
without ulceration |
| T4b |
with ulceration |
Regional Lymph Nodes (N)
| N Category |
Stage Category Definitions |
| NX |
Regional lymph nodes cannot be assessed |
| N0 |
No regional lymph node metastasis |
| N1 |
1 node |
| N1a |
micrometastasis* |
| N1b |
macrometastasis** |
| N2 |
2-3 nodes |
| N2a |
micrometastasis* |
| N2b |
macrometastasis** |
| N2c |
in transit met(s)/satellite(s) without metastatic nodes |
| N3 |
Clinical: ≧ 1 node with in transit met(s)/ satellite(s); pathologic: 4 or more metastatic
nodes, or matted nodes, or in transit met(s)/ satellite(s) with metastatic node(s) |
*Micrometastases are diagnosed after sentinel lymph node biopsy and completion
lymphadenectomy (if performed).
**Macrometastases are defined as clinically detectable nodal metastases confirmed by
therapeutic lymphadenectomy or when nodal metastasis exhibits gross extracapsular
extension.
Distant Metastasis (M)
| M Category |
Stage Category Definitions |
| M1a |
Metastases to skin, subcutaneous tissues, or distant lymph nodes |
| M1b |
Metastases to lung |
| M1c |
Metastases to all other visceral sites or distant metastases to any site combined
with an elevated serum LDH |
No distant metastasis (no pathologic M0; use clinical M to complete stage group)
Anatomic Stage/Prognostic Groups
| Stage |
T |
N |
M |
| 0 |
Tis |
N0 |
M0 |
| IA |
T1a |
N0 |
M0 |
| IB |
T1b |
N0 |
M0 |
| IB |
T2a |
N0 |
M0 |
| IIA |
T2b |
N0 |
M0 |
| IIA |
T3a |
N0 |
M0 |
| IIB |
T3b |
N0 |
M0 |
| IIB |
T4a |
N0 |
M0 |
| IIC |
T4b |
N0 |
M0 |
| IIIA |
T1-4a |
N1a |
M0 |
| IIIA |
T1-4a |
N2a |
M0 |
| IIIB |
T1-4b |
N1a |
M0 |
| IIIB |
T1-4b |
N2a |
M0 |
| IIIB |
T1-4a |
N1b |
M0 |
| IIIB |
T1-4a |
N2b |
M0 |
| IIIB |
T1-4a |
N2c |
M0 |
| IIIC |
T1-4b |
N1b |
M0 |
| IIIC |
T1-4b |
N2b |
M0 |
| IIIC |
T1-4b |
N2c |
M0 |
| IIIC |
Any T |
N3 |
M0 |
| IV |
Any T |
Any N |
M1 |
+ 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 IA patients are
the exception; they do not require pathologic evaluation of their lymph
nodes.
