The value of current staging systems for melanoma of the extremities

The validity of current staging systems for malignant melanoma was analyzed in a prospective study on 220 patients with extremity melanoma. Patients were followed 2 to 9 years after a wide excision of the primary, regional cytostatic perfusion and dissection of regional lymph nodes. The "original three-stage" system yielded statistically significant differentiation, but with a distinct preference for Stage I. The classification into IA/B, and IIIA/B/C according to the M.D. Anderson system does not distribute the patients into significantly different tumor stages. Using the American Joint Committee of Cancer Staging and End Results Reposting (AJCC) system, 40 patients were classified as Stage I, 95 as Stage II, 53 as Stage III, and 32 patients as Stage IV. The 5-year survival rate was 96% in Stage I, 90% in Stage II, 68% in Stage III, and 30% in Stage IV. According to the UICC staging system there was a numerical preference of Stage II and III. The differentiation of Stage I and II was not significant. It is the authors' opinion that the AJCC staging system allows the best differentiation of melanoma patients into tumor stages that are evenly distributed and significant for prognoses.