Open AccessAJCC 8th Edition (2017) versus AJCC 7th Edition (2010) in thin melanoma staging
Author(s) -
Luca Roncati,
Francesco Piscioli
Publication year - 2018
Publication title -
neoplasma
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.628
H-Index - 50
eISSN - 1338-4317
pISSN - 0028-2685
DOI - 10.4149/neo_2018_170701n452
Subject(s) - melanoma , medicine , cancer , breslow thickness , oncology , cancer research , breast cancer , sentinel lymph node
In comparison with the 7th Edition, the 8th Edition of the American Joint Committee on Cancer (AJCC) staging system no longer considers the mitotic count in the a or b T1 categorization for melanoma, but it adopts a sub-stratification based on the Breslow's depth. Today, the death burden of thin melanoma is still severe, despite of attempts for early screening. We believe that a bio-histological implementation may explain this evidence. It is generally accepted that melanoma progression includes two subsequent phases: the radial growth phases (RGP) and the vertical growth phase (VGP). If left untreated, RGP is able to move towards VGP. In this second phase, melanoma grows as a malignant, mitotically active, tumor with invasive and metastatic capacities. By our experience, thin melanoma includes three bio-histological subtypes: the non-tumorigenic micro-invasive RGP without significant regression, the micro-invasive RGP with regression of uncertain tumorigenic potential at diagnosis, due to the extensive presence (> 75%) of regression which could contain a VGP clone, and the micro-invasive tumorigenic VGP. Therefore, we are prone to support that the prognosis of thin melanoma is correlated with the type of growth phase inside it.