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. 2013 Sep;6(9):18–26.

TABLE 1.

TNM staging categories for cutaneous melanoma

CLASSIFICATION THICKNESS (MM) ULCERATION STATUS/MITOSES
T in situ NA NA
T1 ≤1.0

  1. Without ulceration and mitosis <1/mm2

  2. With ulceration or mitoses ≥1/mm2
T2 1.01–2.00

  1. Without ulceration

  2. With ulceration
T3 2.01–4.00

  1. Without ulceration

  2. With ulceration
T4 >4.00

  1. Without ulceration

  2. With ulceration
N Number of Metastatic Nodes Nodal Metastatic Burden
N0 0 NA
N1 1

  1. Micrometastases1

  2. Macrometastases2
N2 2

  1. Micrometastases1

  2. Macrometastases2

  3. In transit metastases/satellites without metastatic nodes
N3 4+ metastatic nodes or matted nodes or in transit metastases/satellites with metastatic nodes
M Site Serum LDH
M0 No distant metastases NA
M1a Distant skin, subcutaneous or nodal metastases Normal
M1b Lung metastases Normal
M1c All other visceral metastases Normal
M1c Any distant metastases Elevated

Abbreviations: NA=not applicable; LDH=lactate dehydrogenase

1

Micrometastases are diagnosed after sentinel lymph node biopsy.

2

Macrometastases are defined as clinically detectable nodal metastases confirmed pathologically.

Adapted from Balch CM, Gershenwald JE, Soong S, et al. Final version of 2009 AJCC Melanoma Staging Guidelines. J Clin Oncol. 2009;27(61):6199–6206.