Osteosarcoma staging

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

Staging

• Historically, the Enneking staging system for skeletal malignancies was widely used.
• 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 International Union Against Cancer (UICC) uses the TNM system to describe the extent of many solid tumor cancers.

TNM

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 the 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 tumour 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