Osteosarcoma staging: Difference between revisions
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==Overview== | ==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. | 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 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. | ||
*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.<ref name=National | *The American Joint Committee on Cancer (AJCC) staging system for [[malignant]] bone tumors has updated this staging system, substituting compartmentalization with size.<ref name="National">{{cite web | title = Osteosarcoma and Malignant Fibrous Histiocytoma of Bone Treatment–for health professionals | ||
| url =http://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq#section/_21}}</ref> | | url =http://www.cancer.gov/types/bone/hp/osteosarcoma-treatment-pdq#section/_21}}</ref> | ||
*The International Union Against Cancer (UICC) uses the TNM system to describe the extent of many solid tumor cancers. | *The International Union Against Cancer (UICC) uses the [[TNM system]] to describe the extent of many solid tumor [[cancers]]. | ||
*For the purpose of treatment, there are only two stages of high-grade osteosarcoma: | *For the purpose of treatment, there are only two stages of high-grade osteosarcoma: | ||
'''Localized osteosarcoma:''' | '''Localized osteosarcoma:''' | ||
*Localized tumors are limited to the bone of origin. | *[[Localized mastocytosis|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. | *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:''' | '''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. | *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=== | ===TNM=== | ||
TNM stands for tumor, nodes, metastasis. TNM staging describes:<ref name=Canadian | [[TNM]] stands for [[tumor]], [[Lymph nodes|nodes]], [[metastasis]]. TNM staging describes:<ref name="Canadian">{{cite web | title = Stages of Bone Cancer| url =http://www.cancer.ca/en/cancer-information/cancer-type/bone/staging/?region=bc}}</ref> | ||
*The size and extent of the primary tumor. | *The size and extent of the primary tumor. | ||
*The number and location of any regional lymph nodes that have cancer cells in them. | *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. | *Whether the cancer has spread or metastasized to another part of the body. | ||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | {| 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 48: | Line 48: | ||
| style="padding: 5px 5px; background: #e4e4e4;" | III | | style="padding: 5px 5px; background: #e4e4e4;" | III | ||
|style="padding: 5px 5px; background: #e4e4e4; | | colspan="2" style="padding: 5px 5px; background: #e4e4e4;" | Any tumor grade, skip metastases. | ||
|- | |- | ||
| style="padding: 5px 5px; background: #e4e4e4;" | IV | | style="padding: 5px 5px; background: #e4e4e4;" | IV | ||
| style="padding: 5px 5px; background: #e4e4e4; | | colspan="2" style="padding: 5px 5px; background: #e4e4e4;" | Any tumor grade, any tumor size, distant metastases. | ||
|} | |} | ||
Revision as of 16:48, 29 May 2018
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Osteosarcoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Osteosarcoma staging On the Web |
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American Roentgen Ray Society Images of Osteosarcoma staging |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [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
- 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.[1]
- The International Union Against Cancer (UICC) uses the TNM system to describe the extent of many solid tumor cancers.
- For the purpose of treatment, there are only two stages of high-grade osteosarcoma:
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
TNM stands for tumor, nodes, metastasis. TNM staging describes:[2]
- 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.
| 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. | |