Osteosarcoma staging: Difference between revisions

Jump to navigation Jump to search
← Older edit
VisualWikitext
Suveenkrishna Pothuru (talk | contribs)
CMEUser, nocaptcha, Administrators
4,365 edits
No edit summary
Gunnam (talk | contribs)
nocaptcha, Administrators
8,766 edits
 
(27 intermediate revisions by 5 users not shown)
Line 1: Line 1:
__NOTOC__
__NOTOC__
{{Osteosarcoma}}
{{Osteosarcoma}}
{{CMG}};{{AE}} {{PSK}}
{{CMG}}; {{AE}} [[User:DrMars|Mohammadmain Rezazadehsaatlou[2]]].
==Overview==
==Overview==
According to the [[American Joint Committee on Cancer]] ([[American Joint Committee on Cancer|AJCC]]), there are four stages of [[osteosarcoma]] based on the size of [[primary tumor]], [[metastasis]], involvement of [[lymph nodes]], and grade of the tumor. For the purpose of treatment, there are only two stages of high-grade [[osteosarcoma]]: [[Localized disease|localized]] [[osteosarcoma]] and [[metastatic]] [[osteosarcoma]].
==Staging==
==Staging==
*Historically, the Enneking staging system for skeletal malignancies was widely used.
*Historically, the Enneking staging system for [[skeletal]] [[malignancies]] was widely used.<ref name="pmid25070231">{{cite journal |vauthors=Moore DD, Luu HH |title=Osteosarcoma |journal=Cancer Treat. Res. |volume=162 |issue= |pages=65–92 |date=2014 |pmid=25070231 |doi=10.1007/978-3-319-07323-1_4 |url=}}</ref><ref name="pmid28195881">{{cite journal |vauthors=Cates JM |title=Comparison of the AJCC, MSTS, and Modified Spanier Systems for Clinical and Pathologic Staging of Osteosarcoma |journal=Am. J. Surg. Pathol. |volume=41 |issue=3 |pages=405–413 |date=March 2017 |pmid=28195881 |doi=10.1097/PAS.0000000000000774 |url=}}</ref><ref name="pmid29182106">{{cite journal |vauthors=Biazzo A, De Paolis M |title=Multidisciplinary approach to osteosarcoma |journal=Acta Orthop Belg |volume=82 |issue=4 |pages=690–698 |date=December 2016 |pmid=29182106 |doi= |url=}}</ref><ref name="pmid29200101">{{cite journal |vauthors=Cates JMM |title=Modeling Continuous Prognostic Factors in Survival Analysis: Implications for Tumor Staging and Assessing Chemotherapy Effect in Osteosarcoma |journal=Am. J. Surg. Pathol. |volume=42 |issue=4 |pages=485–491 |date=April 2018 |pmid=29200101 |doi=10.1097/PAS.0000000000000995 |url=}}</ref><ref name="pmid27138473">{{cite journal |vauthors=Jeys LM, Thorne CJ, Parry M, Gaston CL, Sumathi VP, Grimer JR |title=A Novel System for the Surgical Staging of Primary High-grade Osteosarcoma: The Birmingham Classification |journal=Clin. Orthop. Relat. Res. |volume=475 |issue=3 |pages=842–850 |date=March 2017 |pmid=27138473 |pmc=5289182 |doi=10.1007/s11999-016-4851-y |url=}}</ref>
*This system inferred the aggressiveness of the primary tumor by the descriptors intracompartmental or extracompartmental.
*This system inferred the aggressiveness of the primary tumor by the descriptors intracompartmental or extracompartmental.
*The American Joint Committee on Cancer (AJCC) staging system for malignant bone tumors has updated this staging system, substituting compartmentalization with size.
*The [[American Joint Committee on Cancer]] ([[American Joint Committee on Cancer|AJCC]]) staging system for [[malignant]] bone tumors has updated this staging system, substituting compartmentalization with size.
*The International Union Against Cancer (UICC) uses the TNM system to describe the extent of many solid tumor cancers.
*The [[International Union Against Cancer]] ([[International Union Against Cancer|UICC]]) uses the [[TNM system]] to describe the extent of many solid tumor [[cancers]].
===TNM===
*For the purpose of treatment, there are only two stages of high-grade [[osteosarcoma]]:
TNM stands for tumor, nodes, metastasis. TNM staging describes:
'''Localized osteosarcoma:'''
*The size and extent of the primary tumor.
*[[Localized mastocytosis|Localized]] tumors are limited to the [[bone]] of origin.
*The number and location of any regional lymph nodes that have cancer cells in them
*Patients with skip [[lesions]] confined to the bone that includes the primary tumor are considered to have localized disease if the skip lesions can be included in the planned [[surgical resection]].
*Whether the cancer has spread or metastasized to another part of the body


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
'''Metastatic osteosarcoma:'''
*Patients in whom it is possible to detect any site of [[metastasis]] at the time of initial presentation by routine clinical studies are considered to have [[metastatic]] [[osteosarcoma]].
===TNM Staging system===
[[TNM]] stands for [[tumor]], [[Lymph nodes|nodes]], [[metastasis]]. [[TNM staging system|TNM]] staging describes:
*The size and extent of the primary [[tumor]].
*The number and location of any regional [[Lymph node|lymph nodes]] that have cancer cells in them.
*Whether cancer has spread or [[metastasized]] to another part of the body.
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
|+ '''TNM staging of osteosarcoma'''
|+ '''TNM staging of osteosarcoma'''
! style="background: #4682B4; color:#FFF;" | Stage
! style="background: #4682B4; color:#FFF;" | Stage
Line 22: Line 31:
| style="padding: 5px 5px; background: #e4e4e4;" | IA
| style="padding: 5px 5px; background: #e4e4e4;" | IA
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | Low
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | Low
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | <8 cm
| style="padding: 5px 5px; background: #e4e4e4;" | The [[tumor]] is 8 cm or less in size. It has not spread to lymph nodes or distant sites of the body.
|-
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IB
| style="padding: 5px 5px; background: #e4e4e4;" | IB
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | Low
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | Low
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | >8 cm
| style="padding: 5px 5px; background: #e4e4e4;" | The [[tumor]] is more than 8 cm in size. It has not spread to lymph nodes or distant sites of the body.
|-
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IIA
| style="padding: 5px 5px; background: #e4e4e4;" | IIA
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | High
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | High
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | <8 cm
| style="padding: 5px 5px; background: #e4e4e4;" | The [[tumor]] is 8 cm or less in size. It has not spread to lymph nodes or distant sites of the body.
|-
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IIB
| style="padding: 5px 5px; background: #e4e4e4;" | IIB
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | High
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | High
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | >8 cm
| style="padding: 5px 5px; background: #e4e4e4;" | The [[tumor]] is more than 8 cm in size. It has not spread to lymph nodes or distant sites of the body.
|-
|-
| style="padding: 5px 5px; background: #e4e4e4;" | III
| style="padding: 5px 5px; background: #e4e4e4;" | III


|style="padding: 5px 5px; background: #e4e4e4;" colspan="2" | Any tumor grade, skip metastases
| colspan="2" style="padding: 5px 5px; background: #e4e4e4;" | Any tumor grade, skip [[Metastasis|metastases]].
|-
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IV
| style="padding: 5px 5px; background: #e4e4e4;" | IV
| style="padding: 5px 5px; background: #e4e4e4;" colspan="2" | Any tumor grade, any tumor size, distant metastases
| colspan="2" style="padding: 5px 5px; background: #e4e4e4;" | Any tumor grade, any tumor size, distant metastases.
|}
 
{| style="border: 0px; font-size: 90%; margin: 3px;" align="center"
! colspan="5" |Enneking system for staging malignant musculoskeletal tumors
|-
! style="background: #4682B4; color:#FFF;" | Stage
! style="background: #4682B4; color:#FFF;text-align: center;" | Tumor Grade
! style="background: #4682B4; color:#FFF;text-align: center;" | Tumor site
!
!Tumor Metastasis
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IA
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | Low
| style="padding: 5px 5px; background: #e4e4e4;" | Intracompartmental
|
|No
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IB
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | Low
| style="padding: 5px 5px; background: #e4e4e4;" | Extra Compartimental
|
|No
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IIA
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | High
| style="padding: 5px 5px; background: #e4e4e4;" | Intracompartmental
|
|No
|-
| style="padding: 5px 5px; background: #e4e4e4;" | IIB
| style="padding: 5px 5px; background: #e4e4e4;text-align: center;" | High
| style="padding: 5px 5px; background: #e4e4e4;" | Extra Compartimental
|
|No
|-
| style="padding: 5px 5px; background: #e4e4e4;" | III
 
| style="padding: 5px 5px; background: #e4e4e4;" | Any
|Any
|
|Any (Regional or distant)
|}
|}


Line 51: Line 101:
[[Category:Orthopedics]]
[[Category:Orthopedics]]
[[Category:Mature chapter]]
[[Category:Mature chapter]]
[[Category:Up-To-Date]]
[[Category:Oncology]]
[[Category:Medicine]]
[[Category:Orthopedics]]

Latest revision as of 18:38, 19 October 2019

Osteosarcoma Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Osteosarcoma from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Staging

History and Symptoms

Physical Examination

Laboratory Findings

Biopsy

X Ray

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Osteosarcoma staging On the Web

Most recent articles

cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Osteosarcoma staging

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Osteosarcoma staging

CDC on Osteosarcoma staging

Osteosarcoma staging in the news

Blogs on Osteosarcoma staging

Directions to Hospitals Treating Osteosarcoma

Risk calculators and risk factors for Osteosarcoma staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammadmain Rezazadehsaatlou[2].

Overview

According to the American Joint Committee on Cancer (AJCC), there are four stages of osteosarcoma based on the size of primary tumor, metastasis, involvement of lymph nodes, and grade of the tumor. For the purpose of treatment, there are only two stages of high-grade osteosarcoma: localized osteosarcoma and metastatic osteosarcoma.

Staging

Localized osteosarcoma:

  • Localized tumors are limited to the bone of origin.
  • Patients with skip lesions confined to the bone that includes the primary tumor are considered to have localized disease if the skip lesions can be included in the planned surgical resection.

Metastatic osteosarcoma:

  • Patients in whom it is possible to detect any site of metastasis at the time of initial presentation by routine clinical studies are considered to have metastatic osteosarcoma.

TNM Staging system

TNM stands for tumor, nodes, metastasis. TNM staging describes:

  • The size and extent of the primary tumor.
  • The number and location of any regional lymph nodes that have cancer cells in them.
  • Whether cancer has spread or metastasized to another part of the body.
TNM staging of osteosarcoma
Stage Tumor Grade Tumor Size
IA Low The tumor is 8 cm or less in size. It has not spread to lymph nodes or distant sites of the body.
IB Low The tumor is more than 8 cm in size. It has not spread to lymph nodes or distant sites of the body.
IIA High The tumor is 8 cm or less in size. It has not spread to lymph nodes or distant sites of the body.
IIB High The tumor is more than 8 cm in size. It has not spread to lymph nodes or distant sites of the body.
III Any tumor grade, skip metastases.
IV Any tumor grade, any tumor size, distant metastases.
Enneking system for staging malignant musculoskeletal tumors
Stage Tumor Grade Tumor site Tumor Metastasis
IA Low Intracompartmental No
IB Low Extra Compartimental No
IIA High Intracompartmental No
IIB High Extra Compartimental No
III Any Any Any (Regional or distant)

References

  1. ↑ Moore DD, Luu HH (2014). "Osteosarcoma". Cancer Treat. Res. 162: 65–92. doi:10.1007/978-3-319-07323-1_4. PMID 25070231.
  2. ↑ Cates JM (March 2017). "Comparison of the AJCC, MSTS, and Modified Spanier Systems for Clinical and Pathologic Staging of Osteosarcoma". Am. J. Surg. Pathol. 41 (3): 405–413. doi:10.1097/PAS.0000000000000774. PMID 28195881.
  3. ↑ Biazzo A, De Paolis M (December 2016). "Multidisciplinary approach to osteosarcoma". Acta Orthop Belg. 82 (4): 690–698. PMID 29182106.
  4. ↑ Cates J (April 2018). "Modeling Continuous Prognostic Factors in Survival Analysis: Implications for Tumor Staging and Assessing Chemotherapy Effect in Osteosarcoma". Am. J. Surg. Pathol. 42 (4): 485–491. doi:10.1097/PAS.0000000000000995. PMID 29200101. Vancouver style error: initials (help)
  5. ↑ Jeys LM, Thorne CJ, Parry M, Gaston CL, Sumathi VP, Grimer JR (March 2017). "A Novel System for the Surgical Staging of Primary High-grade Osteosarcoma: The Birmingham Classification". Clin. Orthop. Relat. Res. 475 (3): 842–850. doi:10.1007/s11999-016-4851-y. PMC 5289182. PMID 27138473.
Retrieved from "https://www.wikidoc.org/index.php?title=Osteosarcoma_staging&oldid=1585163"