Clarke Hess 828 Manual Lymphatic Drainage Face
Accepted: 13 September 2017 Abstract Melanoma staging has evolved as our understanding of clinical and pathological risk factors have improved and surgical staging strategies have matured. The current American Joint Committee on Cancer (AJCC) melanoma staging system is based on the tumor (T), node (N), metastasis (M) system, similar to most other solid tumors; criteria that define TNM have changed over time. The T category is determined by primary tumor thickness and presence or absence of ulceration; the N category takes into account both the number of clinically occult and clinically detected lymph node metastases, as well as the presence or absence of non-nodal regional metastases. The M category is defined by anatomic site of disease and lactate dehydrogenase levels. Sentinel lymph node biopsy has become a standard assessment technique by which T2-T4 melanomas, and some T1 melanomas, are staged. Taken together, the melanoma staging system allows for accurate risk stratification of large subsets of melanoma patients that can help guide clinicians and patients regarding prognosis. In the future, melanoma staging may be complemented by validated clinical tools based on multiple clinical, pathological, and molecular risk factors, and may provide a more precise individualized risk assessment for melanoma patients.