Home Neoplasma 2018 Neoplasma Vol.65, No.5, p.651-655, 2018

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Neoplasma Vol.65, No.5, p.651-655, 2018

Title: AJCC 8th Edition (2017) versus AJCC 7th Edition (2010) in thin melanoma staging
Author: L. Roncati, F. Piscioli

Abstract: In comparison with the 7th Edition, the 8th Edition of the American Joint Committee on Cancer (AJCC) staging system no longer considers mitotic count in a or b T1 categorization for melanoma, but it adopts a sub-stratification based on Breslow’s depth. Today, the death burden of thin melanoma is still severe, despite attempts for early screening. We believe that bio-histological implementation can explain this evidence. It is generally accepted that melanoma progression includes two subsequent phases: radial growth phases (RGP) and vertical growth phase (VGP). If left untreated, RGP is able to move towards VGP. In this second phase, melanoma grows as a malignant, mitotically active, tumor with invasive and metastatic capacity. Our experience shows that thin melanoma has three bio-histological subtypes: non-tumorigenic micro-invasive RGP without significant regression; micro-invasive RGP with regression of uncertain tumorigenic potential at diagnosis due to the extensive presence (> 75%) of regression which can contain a VGP clone and micro-invasive tumorigenic VGP. Therefore, we support the conclusion that the diagnosis in melanoma is correlated with the type of growth phase inside it.

Keywords: melanoma; thin melanoma; radial growth phase (RGP); vertical growth phase (VGP); regression; biopsy; histology; American Joint Committee on Cancer (AJCC)
Published online: 24-Sep-2018
Year: 2018, Volume: 65, Issue: 5 Page From: 651, Page To: 655

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