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Dermatopathology: Practical & Conceptual July - September 2002
Flawed Concept: Staging of Melanoma: A Critique in Historical Perspective
Bradley Bakotic, D.O.
A. Bernard Ackerman, M.D.
Systems of Staging in Chronologic Sequence: L.V. Ackerman and Delgato (1947)
American Joint Committee on Cancer (1962–1965)
McNeer and Das Gupta (1964)
M.D. Anderson Cancer Center (1976)
American Joint Committee on Cancer (1977)
Union Internationale Contre Le Cancer (1978)
American Joint Committee on Cancer (1983)
American Joint Committee on Cancer and Union Internationale Contre le Cancer (1988, 1992, 1997)
American Joint Committee on Cancer (2000, 2001)
“Evolution” in Staging is Paralleled by Devolution in Critical Thought
American Joint Committee on Cancer (19621965)
In a series of brochures printed between 1962 and 1965, the American Joint Committee on Cancer (AJCC) Staging and End Results Reporting applied the TNM staging system to breast carcinoma, laryngeal carcinoma, and to various forms of gynecological carcinoma,
TNM standing for Tumor size (T), Nodal status (N), and distant Metastases (M). These parameters were used to stage individuals with different kinds of cancer. By virtue of the influence of this system, McNeer and Das Gupta of the Memorial Sloan-Kettering Cancer Center applied, in 1964, similar principles to the staging of melanoma. They also proposed a system of three tiers designated Stage I, II, and III, and subclassified each of the tiers as follows:
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