Changes in staging criteria will pose some challenges during transition.
The 2009 American Joint Committee on Cancer (AJCC) staging system for melanoma has undergone some changes and is now final. The system relies on data from the AJCC Melanoma Staging Database (updated through 2008), which contains information on 30,946 patients with stages I, II, or III melanoma and 7972 patients with stage IV melanoma. Mitotic count is included for the first time. The use of melanoma thickness (1.0, 2.0, and 4.0 mm) and tumor ulceration remains unchanged. Clark level is eliminated as a staging criterion for thin melanomas.
The adoption of mitotic rate (mitoses/mm2) is the most noteworthy change. Its most significant correlation with survival was identified at a threshold of >1/mm2. In a multifactorial analysis of 10,233 patie…
Reviewing Author
DisclosuresConsultant / advisory board Lubax; WorldCare Clinical
EquityLubax
Grant / Research support NIH; Department of Defense; American Skin Association; Piramal
Editorial boardsBritish Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology
Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)
DisclosuresConsultant / advisory board Lubax; WorldCare Clinical
EquityLubax
Grant / Research support NIH; Department of Defense; American Skin Association; Piramal
Editorial boardsBritish Journal of Dermatology; Journal of the American Academy of Dermatology; Journal of Investigative Dermatology
Leadership positions in professional societies American Academy of Dermatology (Chair, Skin Cancer and Melanoma Committee); American Board of Dermatology (Director)