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    Merkel Cell Carcinoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - Stage Information for Merkel Cell Carcinoma

    Table 4. Regional Lymph Nodes (N)a

    a Reprinted with permission from AJCC: Merkel cell carcinoma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 315-23.
    b Clinical detection of nodal disease may be via inspection, palpation, and/or imaging.
    c Micrometastases are diagnosed after sentinel or elective lymphadenectomy.
    d Macrometastases are defined as clinically detectable nodal metastases confirmed by therapeutic lymphadenectomy or needle biopsy.
    e In transit metastasis: a tumor distinct from the primary lesion and located either (1) between the primary lesion and the draining regional lymph nodes or (2) distal to the primary lesion.
    NX Regional lymph nodes cannot be assessed.
    N0 No regional lymph nodes metastasis.
    cN0 Nodes negative by clinical examb(no pathologic node exam performed).
    pN0 Nodes negative by pathologic exam.
    N1 Metastases in regional lymph node(s).
    N1a Micrometastasis.c
    N1b Macrometastasis.d
    N2 In transit metastasis.e

    Table 5. Distant Metastasis (M)a

    a Reprinted with permission from AJCC: Merkel cell carcinoma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 315-23.
    M0 No distant metastasis.
    M1 Metastases beyond regional lymph nodes.
    M1a Metastases to skin, subcutaneous tissues, or distant lymph nodes.
    M1b Metastasis to lung.
    M1c Metastases to all other visceral sites.

    Table 6. Anatomic Stage/Prognostic Groupsa

    Stage T N M
    a Reprinted with permission from AJCC: Merkel cell carcinoma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 315-23.
    0 Tis N0 M0
    IA T1 pN0 M0
    IB T1 cN0 M0
    IIA T2/T3 pN0 M0
    IIB T2/T3 cN0 M0
    IIC T4 N0 M0
    IIIA Any T N1a M0
    IIIB Any T N1b/N2 M0
    IV Any T Any N M1

    Before the new AJCC consensus staging system was published, the most recent MSKCC four-stage system was favored because it was based on the largest number of patients and was the best validated.[1] The stages in the MSKCC system included:

    • Stage I: local disease <2 cm.
    • Stage II: local disease ≥2 cm.
    • Stage III: regional nodal disease.
    • Stage IV: distant metastatic disease.
    1 | 2 | 3
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