Department of Dermatology, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, South Korea.
Indian J Dermatol Venereol Leprol. 2022 May-Jun;88(3):332-336. doi: 10.25259/IJDVL_680_20.
The tumor, nodes and metastasis (TNM) classification and stage grouping have been updated in the 8th edition of the American Joint Committee on Cancer (AJCC) melanoma staging manual. However, restaging all the previous cases are not recommended.
The aims of the study were to investigate the necessity of restaging Korean melanoma patients staged by the previous edition of the AJCC manual.
Differences in the staging criteria of the 7th and 8th editions of the AJCC manual were identified. The staging of 276 primary melanomas from January 2011 to December 2018 was classified by both 7th and 8th editions of the manual and their differences were compared.
Staging by 7th and 8th edition of the AJCC manual differed in 64 cases (23.2%). The pathological prognostic staging changed in 35 (12.7%), and 29 (10.5%) had changes in only TNM classification but not the pathological staging. None of the patients needed additional sentinel lymph node biopsy or systemic treatment as a result of restaging. Additional counseling was needed for the patients, because melanoma-specific survival was increased in the 8th edition.
This is a retrospective study with relatively small number of patients at a single tertiary center in Korea.
Assessment of the need for additional sentinel lymph node biopsy or systemic treatment is recommended because of the latest changes in the AJCC melanoma staging manual. Although the restaging of previously staged melanomas is not significantly needed in our patients, still the differences in TNM classification and/or pathological prognostic staging suggest the need to separately recognize the patients previously staged by 7th edition and recently staged by 8th edition. Careful counseling about melanoma-specific survival is needed for Asian patients.
第 8 版美国癌症联合委员会（AJCC）黑色素瘤分期手册更新了肿瘤、淋巴结和转移（TNM）分类和分期分组。然而，不建议重新分期所有以前的病例。
本研究旨在探讨重新分期韩国黑色素瘤患者的必要性，这些患者的分期是根据 AJCC 手册前一版进行的。
确定了第 7 版和第 8 版 AJCC 手册分期标准的差异。对 2011 年 1 月至 2018 年 12 月的 276 例原发性黑色素瘤病例，分别采用第 7 版和第 8 版 AJCC 手册进行分期，并比较其差异。
第 7 版和第 8 版 AJCC 手册分期在 64 例（23.2%）中存在差异。病理预后分期改变 35 例（12.7%），仅 TNM 分类改变而病理分期不变 29 例（10.5%）。由于重新分期，没有患者需要额外的前哨淋巴结活检或全身治疗。由于第 8 版黑色素瘤特异性生存率增加，需要对患者进行额外的咨询。
这是一项在韩国单一三级中心进行的回顾性研究，患者数量相对较少。
由于 AJCC 黑色素瘤分期手册的最新变化，建议评估是否需要额外的前哨淋巴结活检或全身治疗。尽管在我们的患者中，重新分期以前分期的黑色素瘤并不显著，但 TNM 分类和/或病理预后分期的差异表明需要分别识别以前按第 7 版分期和最近按第 8 版分期的患者。需要向亚洲患者提供有关黑色素瘤特异性生存率的仔细咨询。
