Radiation Oncology/Bone/Staging
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Bone sarcoma staging
AJCC 7th Edition edit
- Although the AJCC staging is not commonly used in practice, it is technically used for osteosarcoma, chondrosarcoma, Ewing's sarcoma, angiosarcoma, fibrosarcoma, MFH, chordoma, adamantinoma, and other sarcomas. *Excludes lymphoma of bone and multiple myeloma
Primary Tumor:
- T1 - 8 cm or less in greatest dimension
- T2 - >8 cm
- T3 - discontinuous tumors in the primary bone site
Regional Lymph Nodes:
- N0 - no
- N1 - yes
Distant Metastases:
- M0 - no
- M1a - lung
- M1b - other distant sites
Stage Grouping:
- IA - T1 N0, Low grade
- IB - T2 N0, Low grade; or T3 N0, Low grade
- IIA - T1 N0, High grade
- IIB - T2 N0, High grade
- III - T3 N0, High grade
- IVA - M1a
- IVB - N1, M1b
Note: Ewing's sarcoma is classified as grade 4.
Change from AJCC 6th Edition:
- T3 N0 Low Grade moved to IB (was Stage III for low or high grade)
AJCC Older Editions edit
AJCC 6th Edition (2002)
- No changes in TNM compared to 7th edition
- Difference in stage grouping:
Stage Grouping:
- IA - T1 N0, Low grade
- IB - T2 N0, Low grade
- IIA - T1 N0, High grade
- IIB - T2 N0, High grade
- III - T3 N0
- IVA - M1a
- IVB - N1, M1b
Musculoskeletal Tumor Society (MSTS) Staging edit
- IA - low grade, intracompartmental
- IB - low grade, extracompartmental
- IIA - high grade, intracompartmental
- IIB - high grade, extracompartmental
- III - regional or distant metastases