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Blood, 15 July 2007, Vol. 110, No. 2, pp. 479-484.
Prepublished online as a Blood First Edition Paper on March 5, 2007; DOI 10.1182/blood-2006-10-054601.
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REVIEW ARTICLE
TNM classification system for primary cutaneous lymphomas other than mycosis fungoides and Sézary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the Cutaneous Lymphoma Task Force of the European Organization of Research and Treatment of Cancer (EORTC)
Youn H. Kim1,
Rein Willemze2,
Nicola Pimpinelli3,
Sean Whittaker4,
Elise A. Olsen5,
Annamari Ranki6,
Reinhard Dummer7,
Richard T. Hoppe, for the ISCL and the EORTC8
1 Department of Dermatology, Stanford Comprehensive Cancer Center, Stanford, CA;
2 Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands;
3 Department of Dermatological Sciences, University of Florence, Florence, Italy;
4 Skin Tumour Unit, St. Thomas' Hospital, London, United Kingdom;
5 Department of Medicine, Divisions of Dermatology and Oncology, Duke University Medical Center, Durham, NC;
6 Department of Dermatology and Venereal Diseases, Helsinki University Hospital, Helsinki, Finland;
7 Department of Dermatology, University Hospital Zurich, Zurich, Switzerland;
8 Department of Radiation Oncology, Stanford Comprehensive Cancer Center, Stanford, CA
Currently availabel staging systems for non-Hodgkin lymphomas are not useful for clinical staging classification of most primary cutaneous lymphomas. The tumor, node, metastases (TNM) system used for mycosis fungoides (MF) and Sézary syndrome (SS) is not appropriate for other primary cutaneous lymphomas. A usable, unified staging system would improve the communication about the state of disease, selection of appropriate management, standardization of enrollment/response criteria in clinical trials, and collection/analysis of prospective survival data. Toward this goal, during the recent meetings of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC), the representatives have established a consensus proposal of a TNM classification system applicable for all primary cutaneous lymphomas other than MF and SS. Due to the clinical and pathologic heterogeneity of the cutaneous lymphomas, the currently proposed TNM system is meant to be primarily an anatomic documentation of disease extent and not to be used as a prognostic guide.
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