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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, &lt;0.8 mm without ulceration; T1b, 0.8\u20101.0 mm with or without ulceration or &lt;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 \u201cmicroscopic\u201d and \u201cmacroscopic\u201d for regional node metastasis are redefined as \u201cclinically occult\u201d and \u201cclinically apparent\u201d; 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\u2010IIID); 6) definitions of N subcategories are revised, with the presence of microsatellites, satellites, or in\u2010transit metastases now categorized as N1c, N2c, or N3c based on the number of tumor\u2010involved 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\u2010based revision of the AJCC melanoma staging system will guide patient treatment, provide better prognostic estimates, and refine stratification of patients entering clinical trials.\n                    <jats:bold>CA Cancer J Clin 2017;67:472\u2010492.<\/jats:bold>\n                    \u00a9\n                    <jats:bold>2017 American Cancer Society.<\/jats:bold>\n                  <\/jats:p>","DOI":"10.3322\/caac.21409","type":"journal-article","created":{"date-parts":[[2017,10,13]],"date-time":"2017-10-13T10:42:39Z","timestamp":1507891359000},"page":"472-492","source":"Crossref","is-referenced-by-count":1694,"title":["Melanoma staging: Evidence\u2010based changes in the American Joint Committee on Cancer eighth edition cancer staging manual"],"prefix":"10.3322","volume":"67","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4519-5369","authenticated-orcid":false,"given":"Jeffrey E.","family":"Gershenwald","sequence":"first","affiliation":[{"name":"Professor of Surgery and Cancer Biology, Department of Surgical Oncology; Medical Director, Melanoma and Skin Center The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard A.","family":"Scolyer","sequence":"additional","affiliation":[{"name":"Conjoint Medical Director, Melanoma Institute Australia; Clinical Professor The University of Sydney Sydney New South Wales Australia"},{"name":"Senior Staff Pathologist, Royal Prince Alfred Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth R.","family":"Hess","sequence":"additional","affiliation":[{"name":"Professor, Department of Biostatistics The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vernon K.","family":"Sondak","sequence":"additional","affiliation":[{"name":"Chair, Department of Cutaneous Oncology Moffitt Cancer Center Tampa FL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgina V.","family":"Long","sequence":"additional","affiliation":[{"name":"Conjoint Medical Director and Chair of Melanoma Medical Oncology and Translational Research, Melanoma Institute Australia The University of Sydney and Royal North Shore Hospital Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merrick I.","family":"Ross","sequence":"additional","affiliation":[{"name":"Professor of Surgery, Department of Surgical Oncology The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander J.","family":"Lazar","sequence":"additional","affiliation":[{"name":"Professor of Pathology, Dermatology, and Translational Molecular Pathology; Director, Melanoma Molecular Diagnostics The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark B.","family":"Faries","sequence":"additional","affiliation":[{"name":"Co\u2010Director, Melanoma Program; Head, Surgical Oncology The Angeles Clinic and Research Institute Los Angeles CA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John M.","family":"Kirkwood","sequence":"additional","affiliation":[{"name":"Professor of Medicine, Dermatology, and Translational Science The University of Pittsburgh School of Medicine Pittsburgh PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant A.","family":"McArthur","sequence":"additional","affiliation":[{"name":"Executive Director, Victorian Comprehensive Cancer Center Melbourne Victoria Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren E.","family":"Haydu","sequence":"additional","affiliation":[{"name":"Manager, Clinical Data Management Systems The University of Texas MD Anderson Cancer Center Houston TX"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander M. 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