Part of Cancer staging guidance sheets
Malignant melanoma of uvea (ICD10 C69.3, C69.4)
Introduction
This is the data sheet for TNM 8th edition staging of malignant melanoma of uvea (ICD10 C69.3, C69.4).
For more detailed information regarding TNM staging, please see pages 221-225 of the UICC TNM 8 book or visit the Wiley and UICC website.
Stage groupings
|
Stage Group* |
T stage |
N stage |
M stage |
|---|---|---|---|
|
Stage I |
T1a |
N0 |
M0 |
|
Stage IIA |
T1b-d, T2a |
N0 |
M0 |
|
Stage IIB |
T2b, T3a |
N0 |
M0 |
|
Stage IIIA |
T2c-d |
N0 |
M0 |
|
|
T3b-c |
N0 |
M0 |
|
|
T4a |
N0 |
M0 |
|
Stage IIIB |
T3d |
N0 |
M0 |
|
|
T4b-c |
N0 |
M0 |
|
Stage IIIC |
T4d-e |
N0 |
M0 |
|
Stage IV |
Any T |
N1 |
M0 |
|
|
Any T |
Any N |
M1 |
Note:
*The stage groups are for malignant melanoma of the choroid and ciliary body but not of the iris.
TNM clinical classification
T - primary tumour - Iris*
| T value | Description |
|---|---|
|
TX |
Primary tumour cannot be assessed |
|
T0 |
No evidence of primary tumour |
|
T1 |
Tumour limited to iris T1a - not more than 3 clock hours in size T1b - more than 3 clock hours in size T1c - with secondary glaucoma |
|
T2 |
Tumour confluent with or extending into the ciliary body, choroid, or both T2a - Tumour confluent with or extending into the ciliary body without secondary glaucoma T2b - Tumour confluent with or extending into the choroid without secondary glaucoma T2c - Tumour confluent with or extending into the ciliary body and/or choroid with secondary glaucoma |
|
T3 |
Tumour confluent with or extending into the ciliary body, choroid or both, with scleral extension |
|
T4 |
Tumour with extrascleral extension T4a - less than or equal to 5 mm in diameter T4b - more than 5 mm in diameter |
Note:
* Iris melanomas originate from, and are predominantly located in, this region of the uvea. If less than half of the tumour volume is located within the iris, the tumour may have originated in the ciliary body and consideration should be given to classifying it accordingly.
Primary ciliary body and choroidal melanomas are classified according to the four tumour size categories listed in this section. a, b
T - primary tumour - ciliary body and choroid
| T value | Description |
|---|---|
|
TX |
Primary tumour cannot be assessed |
|
T0 |
No evidence of primary tumour |
|
T1 |
Tumour size category 1 T1a - without ciliary body involvement and extraocular extension T1b - with ciliary body involvement T1c - without ciliary body involvement but with extraocular extension less than or equal to 5 mm in diameter |
|
T2 |
Tumour size category 2 T2a - without ciliary body involvement and extraocular extension T2b - with ciliary body involvement T2c - without ciliary body involvement but with extraocular extension less than or equal to 5 mm in diameter T2d - with ciliary body involvement and extraocular extension less than or equal to 5 mm in diameter |
|
T3 |
Tumour size category 3 T3a - without ciliary body involvement and extraocular extension T3b - with ciliary body involvement T3c - without ciliary body involvement but with extraocular extension less than or equal to 5 mm in diameter T3d - with ciliary body involvement and extraocular extension less than or equal to 5 mm in diameter |
|
T4 |
Tumour size category 4 T4a - without ciliary body involvement and extraocular extension T4b - with ciliary body involvement T4c - without ciliary body involvement but with extraocular extension less than or equal to 5 mm in diameter T4d - with ciliary body involvement and extraocular extension less than or equal to 5 mm in diameter T4e - Any tumour size category with extraocular extension more than 5 mm in diameter |
Note:
a - In clinical practice, the largest tumour basal diameter may be estimated in optic disc diameters (dd, average: 1 dd = 1.5 mm). Tumour thickness may be estimated in diopters (average: 2.5 diopters = 1 mm). However, techniques such as ultrasonography and fundus photography are used to provide more accurate measurements. Ciliary body involvement can be evaluated by the slit‐lamp, ophthalmoscopy, gonioscopy, and transillumination. However, high‐frequency ultrasonography (ultrasound biomicroscopy) is used for more accurate assessment. Extension through the sclera is evaluated visually before and during surgery, and with ultrasonography, computed tomography, or magnetic resonance imaging.
b - When histopathological measurements are recorded after fixation, tumour diameter and thickness may be underestimated because of tissue shrinkage.
N - regional lymph nodes
| N value | Description |
|---|---|
|
NX |
Regional lymph nodes cannot be assessed |
|
N0 |
No regional lymph node metastasis |
|
N1 |
Regional lymph node metastasis |
M - distant metastasis
| M value | Description |
|---|---|
|
M0 |
No distant metastasis |
|
M1 |
Distant metastasis M1a - Largest metastases 3 cm or less in greatest dimension M1b - Largest metastases is larger than 3 cm in greatest dimension but not larger than 8 cm M1c - Largest metastases is larger than 8 cm in greatest dimension |
TNM pathological classification
pT - primary tumour
The pT and pN categories correspond to the T and N categories.
Last edited: 12 April 2024 9:57 am
