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Table 3 (AJCC) TNM staging system of vulvar melanoma

From: Extracutaneous melanomas: a primer for the radiologist

Primary tumour (T)
TX: Primary (main) tumour cannot be assessed
T0: No evidence of primary tumour
Tis: Melanoma in situ
T1: The melanoma is less than or equal to 1.0 mm thick
T2: The melanoma is between 1.01 and 2.0 mm thick
T3: The melanoma is between 2.01 and 4.0 mm thick
T4: The melanoma is thicker than 4.0 mm
T1-T4 stages are subdivided into a (without ulceration) and b (with ulceration)
Regional lymph nodes (N)
NX: Regional lymph nodes cannot be assessed
N0: No regional lymph node metastases
N1: Spread to 1 nearby lymph node
N2: Spread to 2 or 3 nearby lymph nodes, OR spread of melanoma to nearby skin (known as satellite tumours) or toward a nearby lymph node area (known as in-transit tumours) without reaching the lymph nodes
N3: Spread to 4 or more lymph nodes, OR spread to lymph nodes that are clumped together, OR spread of melanoma to nearby skin (satellite tumours) or toward a lymph node area and into the lymph node(s)
Distant metastasis (M)
M0: No distant metastasis
M1a: Metastasis to skin, subcutaneous tissue or lymph nodes in distant parts of the body, with a normal blood LDH level
M1b: Metastasis to the lungs, normal LDH level
M1c: Metastasis to other organs or distant spread to any site along with an elevated blood LDH level