Susan Swetter, M.D.

The rationale behind the 2002 AJCC Melanoma Staging Committee recommendations

Swetter SM, Ross MI. The Melanoma Letter. 2001; 19 (4): 1-4

Accurate staging of cutaneous melanoma is essential for proper clinical management. It is also crucial in identification of homogeneous patient populations for meaningful clinical research. In the past two decades, however, the American Joint Committee on Cancer's (AJCC) melanoma staging guidelines have undergone such frequent revision that uncertainty has lingered about what constitutes optimal treatment for different patients. That uncertainty may soon diminish. The latest version of the AJCC guidelines - finalized in August 2001 for general use in 2002 - provides a practical, reproducible staging system that properly reflects the biology of melanoma. The hope is that these new standards will be followed for years to come. The new staging system is solidly evidence-based, incorporating the most important prognostic factors for melanoma as identified by Cox multivariate regression analysis. It can be applied to current clinical practice as well as clinical trials. These long-awaited improvements in the system have resulted from careful analyses of prior staging systems and the development of an unprecedented worldwide, collaborative melanoma database, together providing the most accurate assessment of prognosis to date.