Abstract
In 2002, the International Union Against Cancer (UICC) proposed a new TNM classification for malignant melanoma, adopting the revised staging systemrecently proposed by the American Joint Committee on Cancer (AJCC) . In this classification, tumor thickness is used in the evaluation of primary lesion and Clark's level is applied only to T1 sub-classification. In addition, ulcers in primary lesions, number of regional lymph node metastases, differentiation of macroscopic metastasis from microscopic metastasis to the lymph node, and serum LDH are taken into account in the staging and sub-staging. To evaluate the significance of this new classification for Japanese patients, 342 melanoma patients (214 from the National Cancer Center Hospital and 128 from Shinshu University Hospital) were analyzed by the previous UICC-TNM classification (1997) and this new UICC-TNM classificationo 5-year survival rates by the previous UICC classification were 97.5% at stagel, 86.2% at stage2, 53.2% at stage3, and 13.4% at stage4, and those by the new UICC classification were 95.3% at stagel, 72.8% at stage2, 46.0% at stage3, and 13.4% at stage4. As a result, the 5-year survival rate at each stage of the new UICC classification was a little lower than that of the previous UICC-TNM classification. The new UICC-TNM classification seems to be a better indicator of prognosis for each stage, if the sub-stage categories are taken into account. Further study of a larger nurnber of Japanese patients is required to obtain decisive results. [Skin Cancer (Japan) 2003; 18: 214-220]
