Stage III Melanoma Incidence and Impact of Transitioning to the 8th AJCC Staging System: A US Population-Based Study

Abstract

Aim: To estimate incidence of stage III melanoma using the American Joint Committee on Cancer (AJCC) staging, 7th and 8th edition. Patients & methods: The SEER US cancer registry was analyzed (2010–2014). AJCC7 stages were recorded in the data; AJCC8 stages were inferred. Results: Of 106,195 melanoma patients, 7669 and 7342 had stage III melanoma by AJCC7 and AJCC8, respectively (95% overlap). Nearly 30% of patients with AJCC7 stage III melanoma were reclassified in a higher stage III group by AJCC8 versus 7% in lower stage group. Regardless of the AJCC edition, incidence of stage III melanoma has increased from 2010 to 2014 both overall and within each stage III group. Conclusion: Providing appropriate management to this growing population of high-risk patients is a priority.

Epidemiology and Survival Outcomes in Stages II and III Cutaneous Melanoma: A Systematic Review

“…Another US study which assessed incidence rates in the SEER program, showed an increase in the stage III incidence rate between 2010 and 2014 from 1.21 to 1.48 per 100,000 persons/year (based on American Joint Committee on Cancer [AJCC] 7th edition staging criteria; Table 1). Similar rates were observed when AJCC 8th edition staging criteria was used (2010, n = 1.23 per 100,000 persons/year; 2014, n = 1.47 per 100,000 persons/year) [12]. The statistical significance of this increase was not reported.…”

“…A single Swedish study reported age-adjusted incidence rates for the stage II melanoma population [13]. Unadjusted incidence rates for stages II and III melanoma populations were reported in two studies from the USA (Table 1) [11,12].…”

“…For the remaining studies, we sourced country-specific population estimates using a recent United Nations report (Table 2) [26]. Three studies reported stage II/III data from the USA [12,24,25] and ten studies reported stage II and/or III in seven European countries covering Denmark [15], England [16], Estonia [18], Germany [23], the Netherlands [17], Sweden [13,19,21,22] and Spain [20].…”

“…Stage II incident cases were reported in 13 publications. We identified data from three US studies [12,24,25] and ten European studies (Table 2) [13,[15][16][17][18][19][20][21]23]. The number of incident cases were reported for a range of timeframes covering the period from 1989 to 2016, using data identified from national cancer registries and hospital records.…”

The great debate at “Melanoma Bridge 2018”, Naples, December 1st, 2018

“…Recent updates to the American Joint Committee on Cancer (AJCC) staging guidelines highlight the clinical need for adjuvant therapies in melanoma [34]. Sentinel node staging has become mandatory in the most recent AJCC guidelines, which means fewer patients are being diagnosed with stage I/II disease and more with stage III disease [35]. Because of this, we know more patients have micrometastatic disease.…”