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Annals of Oncology 2009 20(Supplement 6):vi14-vi21; doi:10.1093/annonc/mdp256
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© The Author 2009. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved.
The online version of this article has been published under an open access model. users are entitle to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that: the original authorship is properly and fully attributed; the Journal and the European Society for Medical Oncology are attributed as the original place of publication with the correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions@oxfordjournals.org

This article appears in the following Annals of Oncology issue: Melanoma: Perspectives of the Global Melanoma Task Force [View the issue table of contents]

Articles

Staging of cutaneous melanoma

P. Mohr1,*, A. M. M. Eggermont2, A. Hauschild3 and A. Buzaid4

1 Elbekliniken, Buxtehude, Germany
2 Department of Surgical Oncology, Erasmus University Medical Center–Daniel den Hoed Cancer Center, Rotterdam, The Netherlands
3 Department of Dermatology, University of Kiel, Kiel, Germany
4 Centro de Oncologia do Hospital Sírio-Libanês, Sao Paulo, Brazil

* Correspondence to: Peter Mohr, Elbeklinikum Buxtehude, Am Krankenhaus 1, 21614 Buxtehude, Germany; Tel: +49-4161-703-0; Fax: +49-4161/703-6445; E-mail: mohrpe{at}aol.com

The American Joint Committee on Cancer (AJCC) staging of cutaneous melanoma is a continuously evolving system. The identification of increasingly more accurate prognostic factors has led to major changes in melanoma staging over the years, and the current system described in this review will likely be modified in the near future. Likewise, application of new imaging techniques has also changed the staging work-up of patients with cutaneous melanoma. Chest and abdominal computed tomography (CT) scanning is most commonly used for evaluation of potential metastatic sites in the lungs, lymph nodes and liver, and is indicated in patients with new symptoms, anaemia, elevated lactate dehydrogenase or a chest X-ray abnormality. CT scans should be restricted to patients with high-risk melanoma (stage IIC, IIIB, IIIC and stage IIIA with a macroscopic sentinel lymph node). Magnetic resonance imaging (MRI) of the brain is a mandatory test in patients with stage IV, optional in stage III and not used in patients with stage I and II disease. Positron emission tomography (PET)/CT is more accurate than CT or MRI alone in the diagnosis of metastases and should complement conventional CT/MRI imaging in the staging work-up of patients who have solitary or oligometastatic disease where surgical resection is most relevant.

Key words: follow-up, imaging, melanoma, staging system, staging work-up


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