Stage Information
TNM(B) Definitions
TNM Stage Groupings
The stages that follow are defined by TNM classification. Peripheral blood
involvement with mycosis fungoides or Sézary syndrome (MF/SS) cells is correlated with more
advanced skin stage, lymph node and visceral involvement, and shortened
survival but probably provides no independent prognostic information beyond
that associated with TNM staging. In a multivariate analysis, the two most
important prognostic factors are the presence of visceral disease and type of
skin involvement.
The American Joint Committee on Cancer (AJCC) has designated staging by TNM classification to define mycosis fungoides.[1]
TNM(B) Definitions
Primary tumor (T)
- T1: Limited patch/plaque (<10% of skin surface involved)
- T2: Generalized patch/plaque (≥10% of skin surface involved)
- T3: Cutaneous tumors (one or more)
- T4: Generalized erythroderma
(with or without patches, plaques, or tumors)
[Note: Pathology of T1–T4 is diagnostic of cutaneous T-cell lymphoma (CTCL). When characteristics of more than one T-type tumor exist, both are recorded and the highest is used for staging, for example, T4(3).]
Regional lymph nodes (N)
- N0: Lymph nodes clinically uninvolved; the pathology is negative for
CTCL
- N1: Lymph nodes clinically enlarged, histologically uninvolved; the pathology is negative for CTCL
- N2: Lymph nodes clinically unenlarged, histologically involved; the pathology is positive for
CTCL
- N3: Lymph nodes enlarged and histologically involved; the pathology is positive for CTCL
Distant metastasis (M)
- M0: No visceral disease
- M1: Visceral disease present
The TNM classification includes a subcategory for patients with CTCL:
Blood involvement (B)
- B0: No circulating atypical cells (<1000 Sézary cells [CD4 + CD7-]/mL)
- B1: Circulating atypical cells (≥1000 Sézary cells [CD4 + CD7-]/mL)
TNM Stage Groupings
Stage IA
Stage IB
Stage IIA
Stage IIB
Stage IIIA
Stage IIIB
Stage IVA
- T1–T4, N2, M0
- T1–T4, N3, M0
Stage IVB
- T1–T4, N0, M1
- T1–T4, N1, M1
- T1–T4, N2, M1
- T1–T4, N3, M1
References
-
Lymphoid neoplasms. In: American Joint Committee on Cancer.: AJCC Cancer Staging Manual. 6th ed. New York, NY: Springer, 2002, pp 393-406.
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