Merkel cell cancer staging

Merkel cell cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Merkel Cell Cancer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Staging
History and Symptoms
Physical Examination
Laboratory Findings
CT
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Merkel cell cancer staging On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Merkel cell cancer staging All Images X-rays Echo and Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Merkel cell cancer staging
CDC on Merkel cell cancer staging
Merkel cell cancer staging in the news
Blogs on Merkel cell cancer staging
Directions to Hospitals Treating Merkel cell cancer
Risk calculators and risk factors for Merkel cell cancer staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]

Overview

The staging of Merkel cell cancer is based on the TNM staging system.

Staging

• According to the TNM staging system, merkel cell cancer is classified into 4 stages based on the following:
  • Tumor size
  • Involvement of lymph nodes, and
  • Metastasis
• The stages of Merkel cell carcinoma are shown in the table below:

Stage	Primary Tumor (T)	Lymph Node (N)	Metastasis (M)
0	In situ	No regional lymph node metastasis	No distant metastasis
IA	≤2 cm	Nodes negative by pathologic exam	No distant metastasis
IB	≤2 cm	Nodes negative by clinical exam (no pathologic node exam performed)	No distant metastasis
IIA	>2 cm	Nodes negative by pathologic exam	No distant metastasis
IIB	>2 cm	Nodes negative by clinical exam (no pathologic node exam performed)	No distant metastasis
IIC	Invades bone, muscle and cartilage	No regional lymph node metastasis detected	No distant metastasis
IIIA	Any size tumor (includes invading tumors)	Micrometastasis (diagnosed after sentinel or elective lymphadenectomy)	No distant metastasis
IIIB	Any size tumor (includes invading tumors)	Postive for: Macrometastasis In transit metastasis	No distant metastasis
IV	Any size tumor (includes invading tumors)	Any lymph node metastasis	Metastasis beyond regional lymph nodes

^{Adapted from the American Joint Committee on Cancer (AJCC) - 2009}