Home   Chapter Home   Jobs   Conferences   Fellowships   Books



Advertisement

Skin - Nonmelanocytic tumors

Carcinoma (non-adnexal)

Staging of skin carcinomas


Reviewer: Christopher Hale, M.D. (see Reviewers page)
Revised: 15 July 2012, last major update June 2012
Copyright: (c) 2001-2012, PathologyOutlines.com, Inc.

General
=========================================================================

● Staging of melanomas is described in Skin-Melanocytic tumors chapter
● Staging of related eye tumors is described in the Eye chapter for Conjunctiva, Eyelid, Lacrimal gland
● Includes spindle cell variant of squamous cell carcinoma and adnexal carcinomas
● Applies to clinical and pathologic staging

Primary tumor (T):
TX: Primary tumor cannot be assessed
T0: No evidence of primary tumor
Tis: Carcinoma in situ
T1: Tumor 2 cm or less in greatest dimension with less than 2 high risk features
T2: Tumor more than 2 cm, but not more than 5 cm in greatest dimension
T3: Tumor more than 5 cm in greatest dimension
T4: Tumor invades deep extradermal structures (i.e. cartilage, skeletal muscle or bone)

Note:
● High risk features include:
      ● Depth/invasion: > 2 mm thickness, Clark level of IV or higher or perineural invasion
      ● Anatomic location: primary sites of ear or non-hair bearing lip
      ● Differentiation: poorly differentiated or undifferentiated
● For multiple simultaneous tumors, the tumor with the highest T category will be classified and the number of separate tumors will be indicated in parentheses, e.g. T2 (5)

Regional lymph nodes (N):
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastases
N1: Metastasis in a single ipsilateral lymph node, 3 cm or less in greatest dimension
N2: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension; or in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension; or in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
N2a: Metastasis in a single ipsilateral lymph node, more than 3 cm but not more than 6 cm in greatest dimension
N2b: Metastasis in multiple ipsilateral lymph nodes, none more than 6 cm in greatest dimension
N2c: Metastasis in bilateral or contralateral lymph nodes, none more than 6 cm in greatest dimension
N3: Metastasis in a lymph node, more than 6 cm in greatest dimension

Distant metastasis (M):
M0: No distant metastasis
M1: Distant metastasis

Stage grouping:
Stage 0: Tis N0 M0
Stage I: T1 N0 M0
Stage II: T2 N0 M0
Stage III: T3 N0 M0 or T1-3 N1 M0
Stage IV: T1-3 N2 M0 or any T N3 M0 or T4 any N M0 or any T any N M1

Notes:
● Patients with primary clinical squamous cell carcinoma or other cutaneous carcinomas with no evidence (clinical, radiologic or pathologic) of regional or distant metastases are divided into two stages:
      ● Stage I for tumors measuring 2 cm or less in size
      ● Stage II for those that are greater than 2 cm in size
● If there is clinical concern for extension of tumor into bone and radiologic evaluation is negative, these data may be included to support the Stage I vs. II designation
● Tumors that are 2 cm or less in size can be upstaged to Stage II if they contain two or more high-risk features
● Stage III patients are those with:
      (1) Clinical, histologic or radiologic evidence of one solitary node measuring 3 cm or less in size or
      (2) Tumor extension into bone: maxilla, mandible, orbit or temporal bone
● Stage IV patients are those with:
      (1) Tumor with direct or perineural invasion of skull base or axial skeleton
      (2) 2 or more involved lymph nodes or
      (3) single or multiple involved lymph nodes measuring > 3 cm in size or
      (4) distant metastasis

End of Skin - Nonmelanocytic tumors > Carcinoma (non-adnexal) > Staging of skin carcinomas


This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions (click here for other contact information).