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AJCC Melanoma Staging

AJCC 8th Edition: The standard framework for cutaneous melanoma staging and prognosis.

Primary Tumor (T)

Depth & Ulceration

Regional Nodes (N)

Lymph Node Spread

Distant Met (M)

Spread to Organs

Stage Estimate

Select the T, N, and M categories from the biopsy and pathology reports to determine the AJCC stage.

Guidelines & Evidence

Verified

Last Review: 2026

When to Use

The AJCC 8th Edition Melanoma Staging System is applied to all patients with a confirmed histopathologic diagnosis of primary cutaneous melanoma. It drives surgical management (excision margins, sentinel lymph node biopsy eligibility), systemic therapy decisions (adjuvant immunotherapy or targeted therapy eligibility), surveillance intensity, clinical trial stratification, and prognostic counseling.

Clinical Indications

Any confirmed cutaneous melanoma ≥ 0.8 mm Breslow thickness

Melanoma < 0.8 mm with ulceration (T1b) — SLNB and adjuvant therapy discussions

Any patient with clinically suspicious lymphadenopathy after melanoma diagnosis

Post-excision pathological staging (pTNM) to determine adjuvant eligibility

Surveillance protocol intensity (Stage I vs. II vs. III vs. IV)

When NOT to Use

Ocular/uveal melanoma (different biology and staging system)

Mucosal melanoma (separate AJCC staging criteria)

Desmoplastic melanoma — special considerations for SLNB apply

Pre-biopsy (staging requires pathological tissue data)

Related Scores in Practice

In clinical practice, this assessment is frequently evaluated alongside other validated measures. Depending on the patient's presentation and specific diagnostic requirements, you may also need to utilize the Breslow & Clark Microstaging, Seven Point Dermoscopy, Melanoma Risk Screening or the MSK Melanoma Nomogram to formulate a comprehensive care plan.

Last Comprehensive Review: 2026