LA NECESSITA DI UN NUOVO CRITERIO DI STADIAZIONE DEL MELANOMA

There are several patterns to stage melanoma. At present, the two most important ones are: 1) the M.D. Anderson Hospital (Stehlin); 2) the TNM, a surely most detailed method. Such methods are based on the following prognostic criteria: a) thickness of the lesion (according to Breslow); b) level of invasion (according to Clark); c) evidence of lymphonodal replications. Other parameters are known to influence the five years survival rate (FYSR) of patients suffering from melanoma. These factors are the following: 1) ulceration; 2) sex; 3) age; 4) site; 5) grade of lymphocytic infiltration; 6) histologic type; 7) regression; 8) number of mitosis per square millimetre; 9) growth rate of the cancer. A staging method based on the FYSR and also including the aforesaid parameters is necessary, in order to establish rational criteria for the surgical and medical treatment, as well as for the follow-up. The same concepts can be applied to the staging of other cancers (either cutaneous or not).