NCCN Guidelines for Patients® | Melanoma - page 58

58
NCCN Guidelines for Patients
®
: Melanoma
Version 1.2013
Part 6: A step-by-step treatment guide
6.3 Regional melanoma
Part 6.3.1 describes the recommended tests for stage
III melanoma, also called regional melanoma. Regional
melanoma has spread beyond the primary tumor to
nearby lymph nodes and/or lymph vessels. It has not
spread to distant parts of the body.
Clinical stage I or II melanoma is upstaged to pathologic
stage III if the sentinel lymph node biopsy finds cancer
in the sentinel lymph node. In this case, your doctor may
use imaging tests for staging and to check out specific
signs or symptoms. Possible imaging tests include a CT
scan, a PET/CT scan, and an MRI.
Clinical stage III melanoma is diagnosed when your
doctor feels enlarged lymph nodes during the physical
exam or sees them with imaging tests. Stage III in-transit
melanoma is when cancer cells have spread into nearby
lymph vessels, but not into the lymph nodes. For these
stages, your doctor will perform a biopsy on the enlarged
lymph nodes to test them for cancer cells. An FNA biopsy
is the preferred method, but an excisional lymph node
biopsy is another option. You may also have imaging
tests for staging and to check out specific signs or
symptoms. Possible imaging tests include a CT scan, a
PET/CT scan, and an MRI. For example, you may have a
CT scan of your pelvis if your doctor feels enlarged lymph
nodes in your groin.
Next steps:
For treatment recommendations for stage III
regional melanoma, see Part 6.3.2.
Tests
6.3.1 Tests
Stage
Possible imaging tests for staging or for specific symptoms
Clinical stage I or II upstaged
to pathologic stage III
(Cancer in lymph nodes found
by sentinel lymph node biopsy)
Clinical stage III
(Enlarged lymph nodes found by
physical exam or imaging tests)
• FNA (preferred) or excisional biopsy of enlarged lymph nodes,
and
• Possible imaging tests for staging or for specific symptoms
Stage III in-transit
(Cancer cells found in lymph
vessels but not in lymph nodes)
1...,48,49,50,51,52,53,54,55,56,57 59,60,61,62,63,64,65,66,67,68,...108
Powered by FlippingBook