Primary tumor (T) | ||||
Appendicular skeleton, trunk, skull, and facial bones | ||||
T category | T criteria | |||
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 | |||
Spine | ||||
T category | T criteria | |||
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 confined to three adjacent vertebral segments | |||
T3 | Tumor confined to four or more adjacent vertebral segments, or any nonadjacent vertebral segments | |||
T4 | Extension into the spinal canal or great vessels | |||
T4a | Extension into the spinal canal | |||
T4b | Evidence of gross vascular invasion or tumor thrombus in the great vessels | |||
Pelvis | ||||
T category | T criteria | |||
TX | Primary tumor cannot be assessed | |||
T0 | No evidence of primary tumor | |||
T1 | Tumor confined to one pelvic segment with no extraosseous extension | |||
T1a | Tumor ≤8 cm in greatest dimension | |||
T1b | Tumor >8 cm in greatest dimension | |||
T2 | Tumor confined to one pelvic segment with extraosseous extension or two segments without extraosseous extension | |||
T2a | Tumor ≤8 cm in greatest dimension | |||
T2b | Tumor >8 cm in greatest dimension | |||
T3 | Tumor spanning two pelvic segments with extraosseous extension | |||
T3a | Tumor ≤8 cm in greatest dimension | |||
T3b | Tumor >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 the sacral neuroforamen | |||
T4b | Tumor encasement of external iliac vessels or presence of gross tumor thrombus in major pelvic vessels | |||
Regional lymph nodes (N) | ||||
N category | N criteria | |||
NX | Regional lymph nodes cannot be assessed. Because of the rarity of lymph node involvement in bone sarcomas, the designation NX may not be appropriate, and cases should be considered N0 unless clinical node involvement clearly is evident. | |||
N0 | No regional lymph node metastasis | |||
N1 | Regional lymph node metastasis | |||
Distant metastasis (M) | ||||
M category | M criteria | |||
M0 | No distant metastasis | |||
M1 | Distant metastasis | |||
M1a | Lung | |||
M1b | Bone or other distant sites | |||
Histologic grade (G) | ||||
G | G definition | |||
GX | Grade cannot be assessed | |||
G1 | Well differentiated, low grade | |||
G2 | Moderately differentiated, high grade | |||
G3 | Poorly differentiated, high grade | |||
Prognostic stage groups | ||||
Appendicular skeleton, trunk, skull, and facial bones | ||||
When T is... | And N is... | And M is... | And grade is... | Then the 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 |
There are no prognostic stage groups for the spine and pelvis. |
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