- The M category refers to melanoma distant metastasis and is classified as stage IV:
- Within the M category, there is only one stage, M1:
- In contrast to the three M subcategories in the 7th Edition (M1a, M1b, and M1c):
- There are four subcategories in the 8th Edition AJCC melanoma staging system.
- In contrast to the three M subcategories in the 7th Edition (M1a, M1b, and M1c):
- M1a:
- Distant metastases to the skin, subcutaneous tissue (including muscle), or distant non-lymph nodes:
- They are associated with a better prognosis than metastases to other anatomical sites.
- Distant metastases to the skin, subcutaneous tissue (including muscle), or distant non-lymph nodes:
- M1b:
- Metastases to the lungs are associated with an intermediate prognosis.
- M1c:
- Visceral metastases are associated with a worse prognosis:
- M1c now includes patients with non-CNS visceral metastasis.
- Visceral metastases are associated with a worse prognosis:
- M1d:
- New to the 8th Edition is the addition of a subcategory for CNS metastasis (i.e., brain, spinal cord, and/or leptomeningeal disease):
- This category of disease is generally associated with worse survival compared to the other M categories.
- New to the 8th Edition is the addition of a subcategory for CNS metastasis (i.e., brain, spinal cord, and/or leptomeningeal disease):
- Within the M category, there is only one stage, M1:
- The subcategories reflect survival differences among patients with metastatic disease, depending on the anatomic sites of metastases.
- Serum lactate dehydrogenase (LDH) level also continues to be included in the M category:
- An elevated LDH has been shown to adversely influence survival across patients with stage IV disease.
- LDH level is denoted with the suffix (0) in patients without elevation, or (1) for those with an elevated LDH (i.e., M1a(1) …M1d(1)).
- In patients in whom LDH level is unknown or unspecified, no suffix is added
- The 5-year survival rate refers to the percentage of patients who live at least 5 years after their cancer is diagnosed:
- Relative survival rates take into consideration the fact that people may die of other causes besides melanoma:
- With relative rates, anyone who died of another cause, such as heart disease, is not counted:
- This is considered to be a more accurate way to describe the prognosis for people with particular types and stages of cancer.
- With relative rates, anyone who died of another cause, such as heart disease, is not counted:
- Of course, 5-year survival rates are based on patients diagnosed and initially treated more than 5 years ago:
- Improvements in treatment often result in a more favorable outlook for recently diagnosed patients.
- Relative survival rates take into consideration the fact that people may die of other causes besides melanoma:
- Stage 0:
- The 5-year relative survival rate is 97%.
- Stage I:
- The 5-year survival rate is 90% to 95%:
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year survival is approximately 75%.
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year survival rate is 90% to 95%:
- Stage IIA:
- The 5-year relative survival rate is approximately 85%:
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year survival is approximately 65%.
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year relative survival rate is approximately 85%:
- Stage IIB:
- The 5-year relative survival rate is approximately 72% to 75%:
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year survival is 50% to 60%.
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year relative survival rate is approximately 72% to 75%:
- Stage IIC:
- The 5-year relative survival rate is approximately 53%:
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year survival is approximately 44%.
- If a sentinel node biopsy yields findings of melanoma in the lymph nodes:
- The 5-year relative survival rate is approximately 53%:
- Stage III:
- The 5-year survival rate is approximately 45%:
- It is higher if the melanoma has spread to only one node
- It is lower if it has spread to more than 3.
- It is higher if the spread can only be seen under the microscope.
- It is lower if the melanoma was ulcerated.
- The 5-year survival rate is approximately 45%:
- Stage IV:
- The 5-year survival rate for stage IV melanoma is approximately 10%:
- It is higher if the spread was to skin, subcutaneous tissues or distant non-regional lymph nodes.
- The 5-year survival rate for stage IV melanoma is approximately 10%:
- In a study from Alabama, patients with 1, 2-4, or more than 4 positive node(s) had survival rates of:
- 58%, 27%, and 10%, respectively.
- Patients with spread to the lymph nodes have an 85% chance of developing occult disease.
- The worst outcome is predicted for patients with distant metastasis (stage IV):
- With a single metastatic site, the 1-year survival rate is 36%, but this drops to 13% with 2 sites.
- Patients with 3 or more sites of metastatic disease essentially have a 0% survival rate in the first yea:
- These rates all vary somewhat according to the prognostic characteristics.
Training:
• General surgery:
• Michigan State University:
• 2004 al 2010
• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:
• Fox Chase Cancer Center (Filadelfia):
• 2010 al 2012
• Masters in Science (Clinical research for health professionals):
• Drexel University (Filadelfia):
• 2010 al 2012
• Surgical Oncology / Head and Neck Surgery / Endocrine Surgery:
• IFHNOS / Memorial Sloan Kettering Cancer Center:
• 2014 al 2016
#Arrangoiz
#Surgeon
#Cirujano
#SurgicalOncologist
#CirujanoOncologo
#CancerSurgeon
#CirujanodeCancer
#SkinCancer
#CancerdePiel
#Melanoma
http://www.sociedadquirurigca.com
Rodrigo Arrangoiz MS, MD, FACS, FSSO 