Melanoma Synoptic Report — CAP elements with AJCC 9th Edition (auto stage)
Case / Specimen
Primary tumor / Pathologic features
AJCC 9 (melanoma) pT is defined by Breslow thickness and ulceration. Typical depth cutpoints: Tis = in situ; T1 ≤1.0 mm; T2 >1.0–2.0 mm; T3 >2.0–4.0 mm; T4 >4.0 mm. Ulceration upgrades subcategory. Use pT prefixes (yp/p) for treated specimens. Verify subclass details against the AJCC 9th Edition manual.
Regional nodes / sentinel lymph node
AJCC 9 pN for melanoma documents regional nodal metastasis including microscopically detected metastases, in-transit and satellite disease. pN0 = no regional nodal metastasis; pN1–pN3 are defined by number/location of nodes and presence of in-transit/satellite metastases. Record number of positive nodes, size of nodal deposits, and in-transit findings.
Distant metastasis (pM)
AJCC 9 pM: pM0 = no distant metastasis; pM1 indicates distant disease and is subclassified by site/number. Any pM1 = Stage IV. Include site and method of confirmation when reporting.
AJCC 9 Stage Group Guidance (text included) & Auto-staging
Simplified AJCC 9 stage grouping used by the auto-calculator: - Stage 0: pTis, N0, M0. - Stage I: pT1, N0, M0. - Stage II: pT2–T4, N0, M0. - Stage III: any T, N1–N3, M0 (regional nodal/in-transit disease). - Stage IV: any T, any N, M1 (distant metastasis). Use AJCC 9 tables for exact substaging.