Osteogenic Sarcoma Staging 

Updated: May 10, 2017
  • Author: Nellowe C Candelario, MD; Chief Editor: Edwin Choy, MD, PhD  more...
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TNM Classification for Osteogenic Sarcoma

The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classification and staging system for cancer are provided below. [1] Note that these are based on the AJCC Cancer Staging Manual, 7th Edition (2010). Although the 8th edition has been published, implementation of the new system has been delayed until January 1, 2018. The AJCC advises that, "All newly diagnosed cases through December 31st 2017 should be staged with the 7th edition." [2]

Table 1. TNM Classification for Osteogenic Sarcoma (Open Table in a new window)

Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor ≤ 8 cm in greatest dimension
T2 Tumor > 8 cm in greatest dimension
T3 Discontinuous tumors in the primary bone site
Regional lymph nodes (N)
NX Regional lymph nodes cannot be assessed
N0 No regional node metastasis
N1 Regional lymph node metastasis
Distant metastasis (M)
MX Distant metastasis cannot be assessed
M0 No distant metastasis
M1a Lung only
M1b Other distant sites

Table 2. Histologic Grade (Open Table in a new window)

Histologic grade (G)
GX Grade cannot be assessed
G1 Well differentiated – low grade
G2 Moderately differentiated – low grade
G3 Poorly differentiated
G4 Undifferentiated

Table 3. Stage Grouping (Open Table in a new window)

Stage T N M Grade
IA T1 N0 M0 G1,2 low grade, GX
IB T2 N0 M0 G1,2 low grade, GX
  T3 N0 M0 G1,2 low grade, GX
IIA T1 N0 M0 G3,4 high grade
IIB T2 N0 M0 G3,4 high grade
III T3 N0 M0 G3
IVA Any T N0 M1a Any G
IVB Any T N1 Any M Any G
IVB Any T Any N M1b Any G