Stage 2 Melanoma

Stage 2 melanoma extends beyond the epidermis (very outer layer of skin) into the thicker dermis layer of the skin. It is thicker than stage 1 melanoma and slightly more likely to metastasize (spread to other parts of the body). Stage 2 melanoma has not spread to the lymph tissues, lymph nodes, or body organs. If stage 2 melanoma is initially suspected after a biopsy, your doctor may suggest a sentinel lymph node biopsy (SLNB) to confirm that the melanoma has not spread to the nearest lymph node (in which case it would be stage 3 or 4).

Stage 2 melanoma is divided into three subgroups:‍

• ‍Stage 2A: The melanoma tumor is more than 1 mm and up to 2 mm thick (up to the size of a new crayon point) with ulceration (broken skin due to the cancer) or more than 2 mm and up to 4 mm without ulceration.‍
• Stage 2B: The melanoma tumor is more than 2 mm and up to 4 mm thick with ulceration or more than 4 mm without ulceration. ‍
• Stage 2C: The melanoma tumor is more than 4 mm thick with ulceration.

Treatment for Stage 2 Melanoma

Stage 2A melanoma is treated by removing the tumor surgically. Wide local excision, a minor surgery, usually cures local melanoma. Learn more about melanoma treatments.

For stage 2B or 2C melanoma, surgery and SLNB are generally recommended. Sometimes, adjuvant immunotherapy (therapy given after surgery) with the drugs pembrolizumab or nivolumab may be recommended to reduce the chance of the melanoma coming back.

Clinical Trials

Clinical trials offer patients access to treatment approaches that may be more beneficial than those currently approved by the U.S. Food and Drug Administration (FDA). In addition, clinical trials increase our understanding of melanoma and improve future treatment options for all patients. Given the very rapid development of new agents and combinations, patients are highly encouraged to talk to their physicians about the option of enrolling in a clinical trial for initial treatment and at the time of disease progression. Learn more about clinical trials.

Prognosis for Stage 2 Melanoma

With appropriate treatment, stage 2 melanoma is considered intermediate to high risk for recurrence or metastasis. For stage 2 melanoma, the melanoma-specific survival rate ranges from 94% to 82% 5 years after the initial melanoma diagnosis. 

Follow-Up Care for Stage 2 Melanoma

• Stage 2A: You should undergo a physical exam with a focus on the skin and regional lymph nodes by your doctor every 6 to 12 months for the first 5 years, and then annually as needed. Imaging tests may be ordered as needed to monitor for recurrence.
• Stage 2B and 2C: You should undergo a physical exam with a focus on the skin and regional lymph nodes by your doctor every 3 to 6 months for the first 2 years, then every 3 to 12 months for the next 3 years, and then annually as needed. Imaging tests may be ordered every 3 to 12 months for the first 2 years and then every 6 to 12 months for another 1 to 3 years to monitor for recurrence.