Tumor-Klassifikation und Stadieneinteilung

Hallo!
Ich wollte diese Aufstellung auch einmal hier abbilden, weil sie von dem herkömmlichen Schema abweicht. Hier werden alle Melanome bis zu 1mm in einem Stadium zusammengefasst! Die magische 0,75mm-Grenze kommt nicht vor!
Link: https://www.meb.uni-bonn.de/cancer.g...000062917.html


TNM definitions
Primary tumor (T)
TX: Primary tumor cannot be assessed (e.g., shave biopsy or regressed melanoma)
T0: No evidence of primary tumor
Tis: Melanoma in situ
T1: Tumor 1.0 mm or less in thickness with or without ulceration
T1a: Tumor 1.0 mm or less in thickness and Clark’s level II or III, no ulceration
T1b: Tumor 1.0 mm or less in thickness and Clark’s level IV or V or with ulceration
T2: Tumor more than 1.0 mm but not more than 2.0 mm in thickness with or without ulceration
T2a: Tumor more than 1.0 mm but not more than 2.0 mm in thickness, no ulceration
T2b: Tumor more than 1.0 mm but not more than 2.0 mm in thickness, with ulceration
T3: Tumor more than 2.0 mm but not more than 4 mm in thickness with or without ulceration
T3a: Tumor more than 2.0 mm but not more than 4 mm in thickness, no ulceration
T3b: Tumor more than 2.0 mm but not more than 4 mm in thickness, with ulceration
T4: Tumor more than 4.0 mm in thickness with or without ulceration
T4a: Tumor more than 4.0 mm in thickness, no ulceration
T4b: Tumor more than 4.0 mm in thickness, with ulceration
Regional lymph nodes (N)
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastasis
N1: Metastasis to 1 lymph node
N1a: Clinically occult (microscopic) metastasis
N1b: Clinically apparent (macroscopic) metastasis
N2: Metastasis to 2 or 3 regional nodes or intralymphatic regional metastasis without nodal metastases
N2a: Clinically occult (microscopic) metastasis
N2b: Clinically apparent (macroscopic) metastasis
N2c: Satellite or in-transit metastasis without nodal metastasis
N3: Metastasis in 4 or more regional nodes, or matted lymph nodes, or in-transit metastasis or satellite(s) with metastatic regional node(s)
Micrometastases are diagnosed after elective or sentinel lymphadenectomy; macrometastases are defined as clinically detectable lymph nodes metastases confirmed by therapeutic lymphadenectomy, or when any lymph node metastasis exhibits gross extracapsular extension.

Distant Metastasis (M)
MX: Distant metastasis cannot be assessed
M0: No distant metastasis
M1: Distant metastasis
M1a: Metastasis to skin, subcutaneous tissues, or distant lymph nodes
M1b: Metastasis to lung
M1c: Metastasis to all other visceral sites or distant metastasis at any site associated with an elevated serum lactic dehydrogenase (LDH)
Clinical staging
Clinical staging includes microstaging of the primary melanoma and clinical and/or radiologic evaluation for metastases. By convention, it should be assigned after complete excision of the primary melanoma with clinical assessment for regional and distant metastases. [3]

AJCC stage groupings
Stage 0
Tis, N0, M0
Stage IA
T1a, N0, M0
Stage IB
T1b, N0, M0
T2a, N0, M0
Stage IIA
T2b, N0, M0
T3a, N0, M0
Stage IIB
T3b, N0, M0
T4a, N0, M0
Stage IIC
T4b, N0, M0
Stage III
Any T, N1, M0
Any T, N2, M0
Any T, N3, M0
Stage IV
Any T, any N, M1
Pathologic staging
With the exception of clinical stage 0 or stage IA patients (who have a low risk of lymphatic involvement and do not require pathologic evaluation of their lymph nodes), pathologic staging includes microstaging of the primary melanoma and pathologic information about the regional lymph nodes after sentinel node biopsy and, if indicated, complete lymphadenectomy. [3]