# Melanoma staging: evidence-based changes in the AJCC eighth edition cancer staging manual

Source: https://onco.cc/key-papers/paper-ajcc-8-melanoma-gershenwald-ca-2017/  
OnCo record `paper-ajcc-8-melanoma-gershenwald-ca-2017` (Key paper). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

The eighth-edition melanoma staging system, derived from over 46,000 patients, refined thickness cut-offs and node categories and created the stage IIIA to IIID subgroups whose very different outlooks now guide adjuvant therapy decisions.

## Summary

Description of the American Joint Committee on Cancer eighth-edition staging for melanoma, based on an international database of 46,000 patients, including changes to T1 subcategories, removal of mitotic rate from T1 staging, revised N categories incorporating microsatellites and in-transit disease, new stage III subgroups, and M1 subcategories with lactate dehydrogenase.

## Fields

- Kind: Key paper
- Last checked: 2026-09-17
- Journal: CA: A Cancer Journal for Clinicians
- Year: 2017
- DOI: 10.3322/caac.21409
- Authors: Gershenwald JE, Scolyer RA, Hess KR, et al.
- Findings: Five-year melanoma-specific survival ranges from 93 percent in stage IIIA to 32 percent in stage IIID.; Stage IIB and IIC have worse survival than stage IIIA.
- What it means: Stage IIB, IIC and III on this site's melanoma pages, and the recognition that stage IIIA has a better prognosis than stage IIB or IIC, come from this system.
- Caveats: Survival estimates predate modern adjuvant therapy.

## Sources

- CA Cancer J Clin 2017: https://doi.org/10.3322/caac.21409
- PubMed: https://pubmed.ncbi.nlm.nih.gov/29028110/

## Connected records

- cancers: [Stage IIB and IIC melanoma](https://onco.cc/cancers/stage-ii-melanoma/), [Stage III melanoma (after surgery)](https://onco.cc/cancers/stage-iii-melanoma/)
- journals: [CA: A Cancer Journal for Clinicians](https://onco.cc/journals/ca-cancer-journal/)

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