Uveal melanoma staging: Difference between revisions
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{{CMG}}{{AE}}{{Simrat}} | {{CMG}}{{AE}}{{Simrat}} | ||
==Overview== | ==Overview== | ||
According to the American Joint Committee on Cancer, there are four stages of uveal melanoma based on the tumor size, spread to nearby lymph nodes, and metastasis. Each stage is assigned a number 0 through 4 that indicate increasing severity and letters T, N, and M that designate the tumor size, spread to nearby lymph nodes, and metastasis respectively.<ref name="NIH"> Retinoblastoma. National Cancer institute(2015) http://www.cancer.gov/types/eye/hp/intraocular-melanoma-treatment-pdq#section/_100 Accessed on October 21, 2015</ref> | According to the American Joint Committee on Cancer, there are four stages of uveal melanoma based on the [[tumor]] size, spread to nearby [[lymph nodes]], and [[metastasis]]. Each stage is assigned a number 0 through 4 that indicate increasing severity and letters T, N, and M that designate the tumor size, spread to nearby lymph nodes, and metastasis respectively.<ref name="NIH"> Retinoblastoma. National Cancer institute(2015) http://www.cancer.gov/types/eye/hp/intraocular-melanoma-treatment-pdq#section/_100 Accessed on October 21, 2015</ref> | ||
==Staging== | ==Staging== | ||
The most common staging system used for melanoma of the uveal tract was developed by the American Joint Committee on Cancer (AJCC). The TNM system is based on three key pieces of information:<ref name="NIH"> Retinoblastoma. National Cancer institute(2015) http://www.cancer.gov/types/eye/hp/intraocular-melanoma-treatment-pdq#section/_100 Accessed on October 21, 2015</ref> | The most common staging system used for melanoma of the [[uveal tract]] was developed by the American Joint Committee on Cancer (AJCC). The TNM system is based on three key pieces of information:<ref name="NIH"> Retinoblastoma. National Cancer institute(2015) http://www.cancer.gov/types/eye/hp/intraocular-melanoma-treatment-pdq#section/_100 Accessed on October 21, 2015</ref> | ||
*'''T''' describes the size of the primary tumor and/or whether it has invaded nearby structures | *'''T''' describes the size of the primary [[tumor]] and/or whether it has invaded nearby structures | ||
*'''N''' describes whether the cancer has spread to nearby (regional) lymph nodes | *'''N''' describes whether the cancer has spread to nearby (regional) [[lymph nodes]] | ||
*'''M''' indicates whether the cancer has metastasized (spread) to other parts of the body (The most common site of eye melanoma spread is the liver) | *'''M''' indicates whether the cancer has metastasized (spread) to other parts of the body (The most common site of eye melanoma spread is the [[liver]]) | ||
*Numbers or letters appear after T, N and M to provide more details about each of these factors: | *Numbers or letters appear after T, N and M to provide more details about each of these factors: | ||
**The numbers 0 through 4 indicate increasing severity | **The numbers 0 through 4 indicate increasing severity | ||
**The letter X means "cannot be assessed" because the information is not available. | **The letter X means "cannot be assessed" because the information is not available. | ||
**The N and M categories are the same for all uveal melanomas (iris, ciliary body or choroid). | **The N and M categories are the same for all uveal melanomas ([[iris]], [[ciliary body]] or [[choroid]]). | ||
**The T categories, however, are different for these locations. | **The T categories, however, are different for these locations. | ||
===T categories for iris melanoma=== | ===T categories for iris melanoma=== | ||
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! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Tumor location}} | ! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Tumor location}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:TX | :TX | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The main (primary) tumor cannot be assessed; information not known | | style="padding: 5px 5px; background: #F5F5F5;" |The main (primary) tumor cannot be assessed; information not known | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T0 | :T0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No evidence of a primary tumor | | style="padding: 5px 5px; background: #F5F5F5;" |No evidence of a primary tumor | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1 | :T1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor is only in the iris | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor is only in the iris | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1a | :T1a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is only in the iris and touches 1/4 or less of the iris | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is only in the iris and touches 1/4 or less of the iris | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1b | :T1b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is only in the iris and touches more than 1/4 of the iris | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is only in the iris and touches more than 1/4 of the iris | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T1c | :T1c | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is only in the iris and is causing an increase in the eye pressure (glaucoma) | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is only in the iris and is causing an increase in the eye pressure (glaucoma) | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T2 | :T2 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor has grown into the ciliary body or choroid (or both) | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor has grown into the ciliary body or choroid (or both) | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T2a | :T2a | ||
| style="padding: 5px 5px; background: #F5F5F5;" | Tumor has grown into the ciliary body and/or choroid and is causing glaucoma | | style="padding: 5px 5px; background: #F5F5F5;" | Tumor has grown into the ciliary body and/or choroid and is causing glaucoma | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T3 | :T3 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor has grown into the ciliary body and/or choroid and into the sclera | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor has grown into the ciliary body and/or choroid and into the sclera | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T3a | :T3a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor has grown into the ciliary body and/or choroid and into the sclera and is causing glaucoma | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor has grown into the ciliary body and/or choroid and into the sclera and is causing glaucoma | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4 | :T4 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor extends outside the eyeball | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor extends outside the eyeball | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4a | :T4a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The part of the tumor that is outside the eyeball is 5 millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |The part of the tumor that is outside the eyeball is 5 millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4b | :T4b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The part of the tumor that is outside the eyeball is greater than 5 millimeters (about 1/5 of an inch) in size | | style="padding: 5px 5px; background: #F5F5F5;" |The part of the tumor that is outside the eyeball is greater than 5 millimeters (about 1/5 of an inch) in size | ||
|- | |- | ||
|} | |} | ||
===T categories for ciliary body and choroidal melanoma=== | ===T categories for ciliary body and choroidal melanoma=== | ||
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! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Tumor location}} | ! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Tumor location}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:TX | :TX | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The main (primary) tumor cannot be assessed; information not known | | style="padding: 5px 5px; background: #F5F5F5;" |The main (primary) tumor cannot be assessed; information not known | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T0 | :T0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |No evidence of a primary tumor | | style="padding: 5px 5px; background: #F5F5F5;" |No evidence of a primary tumor | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1 | :T1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is either: | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is either: | ||
Line 97: | Line 96: | ||
*From 3.1 to 6 millimeters deep and no more than 9 millimeters across | *From 3.1 to 6 millimeters deep and no more than 9 millimeters across | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1a | :T1a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is not growing into the ciliary body or growing outside the eyeball | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is not growing into the ciliary body or growing outside the eyeball | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1b | :T1b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is growing into the ciliary body | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is growing into the ciliary body | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T1c | :T1c | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T1d | :T1d | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T1 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T2 | :T2 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is one of the following: | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is one of the following: | ||
Line 120: | Line 119: | ||
*From 6.1 to 9.0 millimeters deep and no more than 12.0 millimeters across | *From 6.1 to 9.0 millimeters deep and no more than 12.0 millimeters across | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T2a | :T2a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T2 in size and is not growing into the ciliary body or growing outside the eyeball | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T2 in size and is not growing into the ciliary body or growing outside the eyeball | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T2b | :T2b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T2 in size and is growing into the ciliary body | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T2 in size and is growing into the ciliary body | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T2c | :T2c | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T2 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T2 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T2d | :T2d | ||
| style="padding: 5px 5px; background: #F5F5F5;" | The tumor is T2 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" | The tumor is T2 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T3 | :T3 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is one of the following: | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is one of the following: | ||
Line 144: | Line 143: | ||
*From 12.1 to 15 millimeters deep and 15 millimeters or less across | *From 12.1 to 15 millimeters deep and 15 millimeters or less across | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T3a | :T3a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T3 in size and is not growing into the ciliary body or growing outside the eyeball | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T3 in size and is not growing into the ciliary body or growing outside the eyeball | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T3b | :T3b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T3 in size and is growing into the ciliary body | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T3 in size and is growing into the ciliary body | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T3c | :T3c | ||
| style="padding: 5px 5px; background: #F5F5F5;" |the tumor is T3 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |the tumor is T3 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:T3d | :T3d | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T3 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size. | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T3 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4 | :T4 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is one of the following: | | style="padding: 5px 5px; background: #F5F5F5;" |Tumor size is one of the following: | ||
Line 167: | Line 166: | ||
*Between 12.1 and 15.0 millimeters deep and between 15.1 and 18 millimeters across | *Between 12.1 and 15.0 millimeters deep and between 15.1 and 18 millimeters across | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4a | :T4a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is not growing into the ciliary body or growing outside the eyeball | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is not growing into the ciliary body or growing outside the eyeball | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4b | :T4b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is growing into the ciliary body | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is growing into the ciliary body | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4c | :T4c | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4d | :T4d | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is T4 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:T4e | :T4e | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The tumor is growing outside the eyeball with the part of the tumor that is outside the eyeball greater than 5millimeters across. The tumor can be any size | | style="padding: 5px 5px; background: #F5F5F5;" |The tumor is growing outside the eyeball with the part of the tumor that is outside the eyeball greater than 5millimeters across. The tumor can be any size | ||
|- | |- | ||
|} | |} | ||
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! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Nodal Mass}} | ! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Nodal Mass}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:NX | :NX | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Lymph node cannot be assessed | | style="padding: 5px 5px; background: #F5F5F5;" |Lymph node cannot be assessed | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:N1 | :N1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cancer has not been spread to nearby lymph nodes | | style="padding: 5px 5px; background: #F5F5F5;" |Cancer has not been spread to nearby lymph nodes | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:N2 | :N2 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cancer has spread to nearby lymph nodes | | style="padding: 5px 5px; background: #F5F5F5;" |Cancer has spread to nearby lymph nodes | ||
Line 217: | Line 216: | ||
! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Definition}} | ! style="background: #4479BA; width: 400px;" | {{fontcolor|#FFF|Definition}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:M0 | :M0 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cancer has not spread to distant parts of the body | | style="padding: 5px 5px; background: #F5F5F5;" |Cancer has not spread to distant parts of the body | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center; padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:M1 | :M1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" |Cancer has spread to distant parts of the body | | style="padding: 5px 5px; background: #F5F5F5;" |Cancer has spread to distant parts of the body | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:M1a | :M1a | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The largest area of cancer spread is 3 centimeters (a little over an inch) across or smaller | | style="padding: 5px 5px; background: #F5F5F5;" |The largest area of cancer spread is 3 centimeters (a little over an inch) across or smaller | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:M1b | :M1b | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The largest area of cancer spread is between 3.1 and 8 centimeters across (8 centimeters is a little over 3 inches) | | style="padding: 5px 5px; background: #F5F5F5;" |The largest area of cancer spread is between 3.1 and 8 centimeters across (8 centimeters is a little over 3 inches) | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:M1c | :M1c | ||
| style="padding: 5px 5px; background: #F5F5F5;" |The largest area of cancer spread is 8 centimeters or more across | | style="padding: 5px 5px; background: #F5F5F5;" |The largest area of cancer spread is 8 centimeters or more across | ||
|- | |- | ||
|} | |} | ||
===Anatomic stage or prognostic groups of uveal melanoma=== | ===Anatomic stage or prognostic groups of uveal melanoma=== | ||
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! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''M'''}} | ! style="background: #4479BA; width: 200px;" | {{fontcolor|#FFF|'''M'''}} | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:Stage 1 | :Stage 1 | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
Line 258: | Line 256: | ||
*M0 | *M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:Stage IIA | :Stage IIA | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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*M0 | *M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:Stage IIB | :Stage IIB | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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*M0 | *M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:Stage IIIA | :Stage IIIA | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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*M0 | *M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC; font-weight: bold" | | ||
:Stage IIIB | :Stage IIIB | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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*M0 | *M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
:Stage III C | :Stage III C | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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*M0 | *M0 | ||
|- | |- | ||
| style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | | style="text-align: center;padding: 5px 5px; background: #DCDCDC;font-weight: bold" | | ||
: Stage IV | : Stage IV | ||
| style="padding: 5px 5px; background: #F5F5F5;" | | | style="padding: 5px 5px; background: #F5F5F5;" | | ||
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|- | |- | ||
|} | |} | ||
==References== | |||
{{reflist|2}} | |||
{{WikiDoc Help Menu}} | |||
{{WikiDoc Sources}} | |||
[[Category:Disease]] | |||
[[Category:Ophthalmology]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Oncology]] | |||
[[Category:Medicine]] | |||
[[Category:Ophthalmology]] |
Latest revision as of 17:35, 27 November 2017
Uveal melanoma Microchapters |
Diagnosis |
---|
Treatment |
Case Studies |
Uveal melanoma staging On the Web |
American Roentgen Ray Society Images of Uveal melanoma staging |
Risk calculators and risk factors for Uveal melanoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Simrat Sarai, M.D. [2]
Overview
According to the American Joint Committee on Cancer, there are four stages of uveal melanoma based on the tumor size, spread to nearby lymph nodes, and metastasis. Each stage is assigned a number 0 through 4 that indicate increasing severity and letters T, N, and M that designate the tumor size, spread to nearby lymph nodes, and metastasis respectively.[1]
Staging
The most common staging system used for melanoma of the uveal tract was developed by the American Joint Committee on Cancer (AJCC). The TNM system is based on three key pieces of information:[1]
- T describes the size of the primary tumor and/or whether it has invaded nearby structures
- N describes whether the cancer has spread to nearby (regional) lymph nodes
- M indicates whether the cancer has metastasized (spread) to other parts of the body (The most common site of eye melanoma spread is the liver)
- Numbers or letters appear after T, N and M to provide more details about each of these factors:
- The numbers 0 through 4 indicate increasing severity
- The letter X means "cannot be assessed" because the information is not available.
- The N and M categories are the same for all uveal melanomas (iris, ciliary body or choroid).
- The T categories, however, are different for these locations.
T categories for iris melanoma
Stage | Tumor location |
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The main (primary) tumor cannot be assessed; information not known |
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No evidence of a primary tumor |
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Tumor is only in the iris |
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The tumor is only in the iris and touches 1/4 or less of the iris |
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The tumor is only in the iris and touches more than 1/4 of the iris |
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The tumor is only in the iris and is causing an increase in the eye pressure (glaucoma) |
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Tumor has grown into the ciliary body or choroid (or both) |
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Tumor has grown into the ciliary body and/or choroid and is causing glaucoma |
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Tumor has grown into the ciliary body and/or choroid and into the sclera |
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Tumor has grown into the ciliary body and/or choroid and into the sclera and is causing glaucoma |
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Tumor extends outside the eyeball |
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The part of the tumor that is outside the eyeball is 5 millimeters (about 1/5 of an inch) or less across in size |
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The part of the tumor that is outside the eyeball is greater than 5 millimeters (about 1/5 of an inch) in size |
T categories for ciliary body and choroidal melanoma
Stage | Tumor location |
---|---|
|
The main (primary) tumor cannot be assessed; information not known |
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No evidence of a primary tumor |
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Tumor size is either:
|
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The tumor is T1 in size and is not growing into the ciliary body or growing outside the eyeball |
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The tumor is T1 in size and is growing into the ciliary body |
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The tumor is T1 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
The tumor is T1 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
Tumor size is one of the following:
|
|
The tumor is T2 in size and is not growing into the ciliary body or growing outside the eyeball |
|
The tumor is T2 in size and is growing into the ciliary body |
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The tumor is T2 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
The tumor is T2 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
Tumor size is one of the following:
|
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The tumor is T3 in size and is not growing into the ciliary body or growing outside the eyeball |
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The tumor is T3 in size and is growing into the ciliary body |
|
the tumor is T3 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
The tumor is T3 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size. |
|
Tumor size is one of the following:
|
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The tumor is T4 in size and is not growing into the ciliary body or growing outside the eyeball |
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The tumor is T4 in size and is growing into the ciliary body |
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The tumor is T4 in size and is not growing into the ciliary body but is growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
The tumor is T4 in size and is growing into the ciliary body. It is also growing outside of the eyeball. The part of the tumor that is outside the eyeball is 5millimeters (about 1/5 of an inch) or less across in size |
|
The tumor is growing outside the eyeball with the part of the tumor that is outside the eyeball greater than 5millimeters across. The tumor can be any size |
N categories for iris, ciliary body and choroidal melanomas
N classification | Nodal Mass |
---|---|
|
Lymph node cannot be assessed |
|
Cancer has not been spread to nearby lymph nodes |
|
Cancer has spread to nearby lymph nodes |
M categories for iris, ciliary body, and choroidal melanomas
M Classification | Definition |
---|---|
|
Cancer has not spread to distant parts of the body |
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Cancer has spread to distant parts of the body |
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The largest area of cancer spread is 3 centimeters (a little over an inch) across or smaller |
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The largest area of cancer spread is between 3.1 and 8 centimeters across (8 centimeters is a little over 3 inches) |
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The largest area of cancer spread is 8 centimeters or more across |
Anatomic stage or prognostic groups of uveal melanoma
Stage | T | N | M |
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References
- ↑ 1.0 1.1 Retinoblastoma. National Cancer institute(2015) http://www.cancer.gov/types/eye/hp/intraocular-melanoma-treatment-pdq#section/_100 Accessed on October 21, 2015