Benign:
1 Latent G 0 T 0 M 0
2 Active G 0 T 0 M 0
3 Aggressive G 0 T 1-2 M 0-1
Malignant: Stage determined by three different sub-categories
-Grade: Histology with aid of radiographic findings and clinical correlation
G 1: Low grade, uniform cell type without atypia, few mitoses
G 2: High grade, atypical nuclei, mitoses pronounced
-Site: T 1: Intracompartmental (Confined within limits of periosteum)
T 2: Extracompartmental (Breach in an adjacent joint cartilage, bone cortex (or periosteum)
fascia lata, quadriceps, and joint capsule)
-Metastasis: M 0: No identifiable skip lesions or distant metastases.
M 1: Any skip lesions, regional lymph nodes, or distant metastases.
Enneking's Staging System of Malignant Bone Tumors, CORR 1980
Ia Low grade, intracompartmental G 1 T 1 M 0
Ib Low grade, extracompartmental G 1 T 2 M 0
IIa High grade, intracompartmental G 2 T 1 M 0
IIb High grade, extracompartmental G 2 T 2 M 0
IIIa Low or High grade, intracompart. G 1-2 T 1 M 1
w/ metastases.
IIIb Low or High grade, extracompart. G 1-2 T 2 M 1
w/ metastases.
- Discussion:
-Benign tumor staging uses Arabic numbers (1,2,3)
-Malignant tumors identified with Roman numerals and a letter (Ia, Ib, IIa, IIb, IIIa, IIIb)
-Treatment of any potentially malignant bone tumor always begins with:
- staging: Chest CT scan to evaluate for pulmonary metastasis, bone scan or skeletal survey for distant metastases or skip lesions
- biopsy
- radiographic features
Grading of bone tumors by analysis of nuclear DNA content using flow cytometry.
Principles of staging of soft-tissue sarcomas.
Staging of soft-tissue sarcomas. Prognostic analysis of clinical and pathological features.
Scintigraphy with gallium-67 citrate in staging of soft-tissue sarcomas of the extremity.
Current concepts review. The surgical staging of musculoskeletal staging of musculoskeletal sarcoma.
A system for the surgical staging of musculoskeletal sarcoma.
New Developments in the staging and imaging of soft tissue sarcomas.