Radiation Oncology/Bone/Staging

Bone sarcoma staging AJCC 7th Edition 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 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 IA - low grade, intracompartmental IB - low grade, extracompartmental IIA - high grade, intracompartmental IIB - high grade, extracompartmental III - regional or distant metastases