TNM Classification for Osteogenic Sarcoma
The American Joint Committee on Cancer (AJCC) tumor/node/metastasis (TNM) classification and staging system for osteogenic sarcoma are provided below. [1]
Table. TNM Classification for Osteogenic Sarcoma (Open Table in a new window)
Primary Tumor (T) | |
Appendicular Skeleton, Trunk, Skull and Facial Bones | |
TX | Primary Tumor cannot be assessed |
T0 | No evidence of primary tumor |
T1 | Tumor less than or equal to 8 cm |
T2 | Tumor more than 8 cm |
T3 | Discontinuous tumors in the primary bone site |
Spine | |
TX | Primary Tumor cannot be assessed |
T0 | No evidence of primary tumor |
T1 | Tumor confined to one vertebral segment or two adjacent vertebral segments |
T2 | Tumor confine to three vertebral segments |
T3 | Tumor confined to four or more adjacent vertebral segments or any nn adjacent segments |
T4 | Extension to the spinal canal or great vessels |
T4a | Extension to the spinal canal |
T4b | Evidence of gross vascular invasionor tumor thrombus in the great vessels |
Pelvis | |
TX | Primary Tumor cannot be assessed |
T0 | No evidence of primary tumor |
T1 | Tumor confine to one pelvic segment with no extraosseous extension |
T1a | Tumor less than or equal to 8 cm in greatest dimension |
T1b | Tumor more than 8 cm in greatest dimension |
T2 | Tumor confined to one pelvic segment with extraosseous extension or two segments without extraossous extension |
T2a | Tumor less than or equal to 8 cm in greatest dimension |
T2b | Tumor more than 8 cm in greatest dimension |
T3 | Tumor spanning two pelvic segments with extraosseous extension |
T3a | Tumor less than or equal to 8 cm in greatest dimension |
T3b | Tumor more than 8 cm in greatest dimension |
T4 | Tumor spanning three pelvic segments or crossing the sacroiliac joint |
T4a | Tumor involves sacroiliac joint and extends medial to sacral neuroforamen |
T4b | Tumor encasement of external iliac vessels or presence of gross tumor thrombus in major pelvic vessels |
Regional lymph nodes (N) | |
NX | Regional lymph nodes cannot be assessed; because of rarity of lymph node involvement in bone sarcomas, the designation of NX may not be appropriate and cases should be considered N0 unless clinical node involvement is clearly evident |
N0 | No regional lymph node metastasis |
N1 | Regional lymph node metastasis |
Distant metastasis (M) | |
M0 | No distant metastasis |
M1 | Distant metastasis |
M1a | Lung |
M1b | Bone and other distant sites |
Histologic grade (G) | |
GX | Grade cannot be assessed |
G1 | Well differentiated, low grade |
G2 | Moderately differentiated, high grade |
G3 | Poorly differentiated, high grade |
Table. Anatomic Stage/Prognostic Groups (Open Table in a new window)
Appendicular Skeleton, Trunk, Skull, and Facial Bones | ||||
When T is … | And N is … | And M is… | And the grade is … | Then stage group is … |
T1 | N0 | M0 | G1 or GX | IA |
T2 | N0 | M0 | G1 or GX | IB |
T3 | N0 | M0 | G1 or GX | IB |
T1 | N0 | M0 | G2 or G3 | IIA |
T2 | N0 | M0 | G2 or G3 | IIB |
T3 | N0 | M0 | G2 or G3 | III |
Any T | N0 | M1a | Any G | IVA |
Any T | N1 | Any M | Any G | IVB |
Any T | Any N | M1b | Any G | IVB |
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