Seventh (2010) TNM staging system for cutaneous melanoma

Primary tumor (T)
TX	Primary tumor cannot be assessed (eg, curettaged or severely regressed primary)
T0	No evidence of primary tumor
Tis	Melanoma in situ
T1	≤1.0 mm
	a: without ulceration and mitoses <1/mm²
	b: with ulceration or mitoses ≥1/mm²
T2	1.01-2.0 mm
	a: without ulceration
	b: with ulceration
T3	2.01-4.0 mm
	a: without ulceration
	b: with ulceration
T4	>4.0 mm
	a: without ulceration
	b: with ulceration
Regional lymph nodes (N)
NX	Patients in whom the regional nodes cannot be assessed (eg, previously removed for another reason)
N0	No regional metastases detected
N1	One lymph node
	a: micrometastases*
	b: macrometastases^¶
N2	Two or three lymph nodes
	a: micrometastases*
	b: macrometastases^¶
	c: in-transit met(s)/satellite(s) without metastatic lymph nodes
N3	Four or more metastatic lymph nodes, or matted lymph nodes, or in-transit met(s)/satellite(s) with metastatic lymph node(s)
Distant metastasis (M)
M0	No detectable evidence of distant metastases
M1a	Metastases to skin, subcutaneous, or distant lymph node, normal serum LDH
M1b	Lung metastases, normal LDH
M1c	Metastasis to other visceral metastases with a normal LDH, or any distant metastases and an elevated LDH

Note: cTNM is the clinical classification, pTNM is the pathologic classification.

TNM: tumor, node, metastasis; LDH: lactic dehydrogenase.
* Micrometastases are diagnosed after sentinel lymph node biopsy and completion lymphadenectomy (if performed).
¶ Macrometastases are defined as clinically detectable lymph node metastases confirmed by therapeutic lymphadenectomy or when any lymph node metastasis exhibits gross extracapsular extension.

Used with the permission of the American Joint Committee on Cancer (AJCC), Chicago, Illinois. The original source for this material is the AJCC Cancer Staging Manual, Seventh Edition (2010) published by Springer New York, Inc.

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Seventh (2010) TNM staging system for cutaneous melanoma