Stage IIID includes: T4b, N3a/b/c, M0. T4b: Tumor measuring more than 4.0 mm in thickness. Ulceration status: With ulceration. N3a: Four or more clinically occult nodal metastasis (i.e., detected by sentinel lymph node biopsy). Presence of in-transit, satellite, and/or microsatellite metastases: No. N3b: Four or more nodal metastases, at least one of which was clinically detected, or presence of any number of matted nodes. Presence of in-transit, satellite, and/or microsatellite metastases: No. N3c: Two or more clinically occult nodal metastases. Presence of in-transit, satellite, and/or microsatellite metastases: Yes. M0: No evidence of distant metastasis. LDH level is not applicable. (AJCC 8th ed.) [from NCI]