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TNM staging

By Mia Wangsmo Steffenssen MD, Mike Mikkelsen Lorenzen, MD and Pia Sjøgren MD

Anatomic stage/prognostic groups

Primaty tumor (T)
TxPrimary tumor cannot be assessed (ie, curretaged or severely regressed melanoma)
T0No evidence of primary tumor
TisMelanoma in situ
T1Melanoma ≤ 1.0 mm in thickness
T1a: Without ulceration and mitoses <1/mm²
T1b: With ulceration or mitoses ≥1/mm²
T2Melanomas 1.01-2.0mm in thickness
T2a: Without ulceration
T2b: With ulceration
T3Melanomas 2.01-4.0 mm in thickness
T3a: Without ulceration
T3b: With ulceration
T4Melanomas > 4.0 mm in thickness
T4a: Without ulceration
T4b: With ulceration
Regional lymph nodes (N)
NxPatients in whom the regional nodes cannot be assessed (ie. previously removed for another reason)
N0No regional metastases detected
N1-3Regional metastases based upon number of metastatic nodes and presence or absence of intralymphatic metastases (in transit or satellite metastases)
N11 lymph node
N1a: Micrometastases
N1b: Macrometastases
N22 or 3 lymph nodes
N1a: Micrometastases
N1b: Macrometastases
N2c: In-transit met(s)/satellite(s) without metastatic lymph nodes
N3≥ 4 metastatic lymph nodes, or matted nodes, or in-transit met(s)/satellite(s) with metastatic lymph node(s)
Distant metastasis (M)
M0No detectable evidence of distant metastases
M1aMetastases to skin, subcutaneous, or distans lymph nodes, normal serum lactate dehydrogenase (LDH) level
M1bLung metastases, normal LDH level
M1cMetastases to all other visceral sites or distant metastases to any site combined with an elevated serum LDH level