A Review of the 7th Edition of the AJCC Staging Manual With Particular Respect to Thin Melanoma, the Importance of an Expert Dermatopathological Review and Accurate Microstaging Implications.

A significant number (81%) of newly diagnosed melanoma patients are of the thin (ie,51 mm) or melanoma in situ category. Since the staging of cutaneous melanoma has recently been revised to include and exclude pathological parameters dealing with thin melanomas, it is increasingly important to incorporate these changes to reflect correct pathological microstaging. We herein review the current AJCC cancer staging system as is relates to melanoma, highlighting a recent study we conducted that demonstrated how expert dermatopathological review at a high volume center can change the stage and ultimately clinical management in thin melanoma patients. This review will discuss the changes reflected in the most recent revision of the 2010 AJCC staging system for malignant melanoma, including detailed instructions of how to approach, interpret, and accurately microstage cutaneous melanoma. Application of the new staging criteria in newly diagnosed melanoma patients at a tertiary care referral center frequently results in changes to treatment-based decisions including surgical excision margins and the performance of a sentinel lymph node biopsy. Key pathological parameters are either frequently omitted or reported incorrectly outside pathology reports. [ABSTRACT FROM AUTHOR]