Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
Melanoma staging: Evidence-based changes in the American Joint Committee on Cancer eighth edition cancer staging manual.
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DOI：
10.3322/caac.21409
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发表时间：
2017-11
期刊：
影响因子：
--
通讯作者：
for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform
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文献类型：
--
作者：
Gershenwald JE;Scolyer RA;Hess KR;Sondak VK;Long GV;Ross MI;Lazar AJ;Faries MB;Kirkwood JM;McArthur GA;Haydu LE;Eggermont AMM;Flaherty KT;Balch CM;Thompson JF;for members of the American Joint Committee on Cancer Melanoma Expert Panel and the International Melanoma Database and Discovery Platform
为了更新美国癌症联合委员会（AJCC）的黑素瘤分期系统，收集了一个大型数据库，该数据库包括自1998年以来诊断为I、II和III期黑素瘤的来自全球10个中心的> 46，000名患者。基于对这个新数据库、现有的第七版AJCC IV期数据库和当代临床试验数据的分析，AJCC黑色素瘤专家小组对肿瘤、淋巴结、转移（TNM）分类和分期分组标准进行了几项重要变更。第八版AJCC癌症分期手册的主要变化包括：1）记录肿瘤厚度测量值，精确到0.1 mm，而不是0.01 mm; 2）修订T1 a和T1 b的定义（T1 a，<0.8 mm，无溃疡; T1 b，0.8-1.0 mm，有或无溃疡或<0.8 mm，有溃疡），有丝分裂率不再是T分类标准;（3）病理性（但非临床）IA期修订为包括T1 b N 0 M0 4）将区域性淋巴结转移的N类描述符“微观”和“宏观”重新定义为“临床隐匿”和“临床明显”; 5）预后III期分组基于N类标准和T类标准（即原发性肿瘤厚度和溃疡），从3个亚组增加到4个亚组（IIIA-IIID期）; 6）修订了N亚类的定义，微卫星、卫星或过境转移的存在现在被归类为N1 c、N2 c，或N3 c，基于肿瘤累及的区域淋巴结数量（如有）; 7）在乳酸脱氢酶（LDH）水平的每个M1亚类名称中添加描述符（LDH升高不再升级为M1 c）; 8）为中枢神经系统转移添加新的M1 d名称。AJCC黑色素瘤分期系统的循证修订将指导患者治疗，提供更好的预后估计，并细化进入临床试验的患者分层。
To update the melanoma staging system of the American Joint Committee on Cancer (AJCC) a large database was assembled comprising >46,000 patients from 10 centers worldwide with stages I, II, and III melanoma diagnosed since 1998. Based on analyses of this new database, the existing seventh edition AJCC stage IV database, and contemporary clinical trial data, the AJCC Melanoma Expert Panel introduced several important changes to the Tumor, Nodes, Metastasis (TNM) classification and stage grouping criteria. Key changes in the eighth edition AJCC Cancer Staging Manual include: 1) tumor thickness measurements to be recorded to the nearest 0.1 mm, not 0.01 mm; 2) definitions of T1a and T1b are revised (T1a, <0.8 mm without ulceration; T1b, 0.8–1.0 mm with or without ulceration or <0.8 mm with ulceration), with mitotic rate no longer a T category criterion; 3) pathological (but not clinical) stage IA is revised to include T1b N0 M0 (formerly pathologic stage IB); 4) the N category descriptors “microscopic” and “macroscopic” for regional node metastasis are redefined as “clinically occult” and “clinically apparent”; 5) prognostic stage III groupings are based on N category criteria and T category criteria (ie, primary tumor thickness and ulceration) and increased from 3 to 4 subgroups (stages IIIA–IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or in-transit metastases now categorized as N1c, N2c, or N3c based on the number of tumor-involved regional lymph nodes, if any; 7) descriptors are added to each M1 subcategory designation for lactate dehydrogenase (LDH) level (LDH elevation no longer upstages to M1c); and 8) a new M1d designation is added for central nervous system metastases. This evidence-based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials.
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影响因子：
45.3
作者：
Buzaid, AC;Ross, MI;Benjamin, RS
通讯作者：
Benjamin, RS
影响因子：
45.3
作者：
Balch, Charles M.;Gershenwald, Jeffrey E.;Sondak, Vernon K.
通讯作者：
Sondak, Vernon K.
影响因子：
6.2
作者：
Cormier, JN;Xing, Y;Ross, MI
通讯作者：
Ross, MI
影响因子：
3.7
作者：
Balch, CM;Soong, SJ;Harrison, R
通讯作者：
Harrison, R
影响因子：
9
作者：
BRESLOW, A
通讯作者：
BRESLOW, A