Once you have the TNM classification, there are two stage groupings based on the clinical and pathological stage as explained previously. These will be more important to your medical team as they will help delineate the type of treatment. As a patient, you will want to know if you are Stage 1, Stage 2, etc.
Take our previous example of a T2bN0M0. Look at the tables for this numeration. It is both a clinical and pathological Stage IIA. So, you would look under Stage IIA melanoma treatment and prognosis for further information. The clinical and pathological stages are the same for Stages 0-IIC. Since clinical staging relies on external “looks” at the lymph nodes, it is cannot be differentiated as well pathological staging for Stages III-IV. This is because the pathological staging includes the surgical excision of lymph nodes and their microscopic examination, an “internal” look at the nodes.
Clinical Stage Grouping
Stage 0 |
Tis |
N0 |
M0 |
Stage IA |
T1a |
N0 |
M0 |
Stage IB |
T1b |
N0 |
M0 |
|
T2a |
N0 |
M0 |
Stage IIA |
T2b |
N0 |
M0 |
|
T3a |
N0 |
M0 |
Stage IIB |
T3b |
N0 |
M0 |
|
T4a |
N0 |
M0 |
Stage IIC |
T4b |
N0 |
M0 |
Stage III |
Any T |
N1 |
M0 |
|
Any T |
N2 |
M0 |
|
Any T |
N3 |
M0 |
Stage IV |
Any T |
Any N |
M1 |
Pathologic Stage Grouping
Stage 0 |
Tis |
N0 |
M0 |
Stage IA |
T1a |
N0 |
M0 |
Stage IB |
T1b |
N0 |
M0 |
|
T2a |
N0 |
M0 |
Stage IIA |
T2b |
N0 |
M0 |
|
T3a |
N0 |
M0 |
Stage IIB |
T3b |
N0 |
M0 |
|
T4a |
N0 |
M0 |
Stage IIC |
T4b |
N0 |
M0 |
Stage IIIA |
T1-4a |
N1a |
M0 |
|
T1-4a |
N2a |
M0 |
Stage IIIB |
T1-4b |
N1a |
M0 |
|
T1-4b |
N2a |
M0 |
|
T1-4a |
N2b |
M0 |
|
T1-4a/b |
N2c |
M0 |
Stage IIIC |
T1-4b |
N1b |
M0 |
|
T1-4b |
N2b |
M0 |
|
Any T |
N3 |
M0 |
Stage IV |
Any T |
Any N |
M1 |
Tables adapted from American Joint Committee on Cancer, 2002. www.cancerstaging.net/chapter.pdf