Implications of the 2009 American Joint Committee on Cancer Melanoma Staging and Classification on Dermatologists and Their Patients
The Melanoma Staging and Classification system was recently revised by the American
Joint Committee on Cancer (AJCC) and implemented effective January 2010 with changes
reflecting new prognostic data gleaned by the significantly larger patient population studied
for the 7th edition. This newest analysis yields important long-term outcome data as many
of the patients were followed for nearly 2 decades. Additions to edition 7 of the AJCC
Melanoma Staging classification highlight several important prognostic factors, particularly
the addition of mitotic rate for classifying thin melanomas, the presence of microtumor
burden in lymph nodes for stage III disease, and elevated lactate dehydrogenase levels in
patients with distant metastatic disease. Although the basic tumor-nodes-metastases (ie,
TNM) cancer classification model remains unchanged in this newest edition, the current
AJCC Melanoma Staging System has incorporated the latest prognostic data to accurately
stratify patients into staging categories. It is important for clinicians and dermatopathologists
to familiarize themselves with these changes so that patients are suitably managed
and referred to medical and surgical oncologists when appropriate.
Semin Cutan Med Surg 29:142-147 © 2010 Elsevier Inc. All rights reserved.