Head and Neck Melanoma

Table 2

AJCC 2009 revised melanoma staging.

Stage	TNM staging	Stage	Pathologic staging	Histologic/clinical features
Stage 0	Tis N0 M0	0	Tis N0 M0	Melanoma in situ
Stage IA	T1a N0 M0	IA	T1a N0 M0	Melanomas ≤ 1 mm without ulceration and mitosis < 1/mm^2
Stage IB	T1b N0 M0	IB	T1b N0 M0	Melanomas ≤ 1 mm with ulceration or mitosis ≥ 1/mm^2
	T2a N0 M0		T2a N0 M0	Melanomas 1.01–2 mm without ulceration
Stage IIA	T2b N0 M0	IIA	T2b N0 M0	Melanomas 1.01–2 mm with ulceration
	T3a N0 M0		T3a N0 M0	Melanomas 2.01–4 mm without ulceration
Stage IIB	T3b N0 M0	IIB	T3b N0 M0	Melanomas 2.01–4 mm with ulceration
	T4a N0 M0		T4a N0 M0	Melanomas 4 mm without ulceration
Stage IIC	T4b N0 M0	IIC	T4b N0 M0	Melanomas 4 mm with ulceration
Stage III	Any T ≥ N1 M0	IIIA	T1-4a N1a M0	Single regional nodal micrometastasis, nonulcerated primary
			T1-4a N2a M0	2-3 regional nodal micrometastasis, nonulcerated primary
		IIIB	T1-4b N1a M0	Single regional nodal micrometastasis, ulcerated primary
			T1-4b N2a M0	2-3 regional nodal micrometastasis, nonulcerated primary
			T1-4a N1b M0	Single regional nodal macrometastasis, nonulcerated primary
			T1-4a N2b M0	2-3 macroscopic regional nodes, no ulceration of primary
			T1–4a N2c M0	2-3 nodes, in-transit met(s)* and/or satellite lesion(s) without metastatic lymph nodes
		IIIC	T1-4b N1b M0	Single regional nodal macrometastasis, ulceration of primary
			T1-4b N2b M0	2-3 macroscopic regional nodes, ulceration of primary
			T1-4b N2c M0	2-3 nodes, in-transit met(s)* and/or satellite lesion(s) without metastatic lymph nodes, ulceration of primary
			Any T N3 M0	4 or more metastatic nodes, or matted nodes, or in-transit met(s)/satellite (s) with metastatic nodes (s)
Stage IV	Any T Any N M1	IV	Any T Any N M1	Distant metastasis
				M1a: distant skin, subcutaneous, or nodal mets with normal LDH levels
				M1b: lung mets with normal LDH levels
				M1c: all other visceral metastases with normal LDH levels
				Distant metastasis with elevated LDH levels