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Radiation Oncology/Bone/Staging

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< Radiation Oncology | Bone
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Bone sarcoma staging


AJCC 7th Edition

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  • Although the AJCC staging is not commonly used in practice, it is technically used for osteosarcoma, chondrosarcoma, Ewing's sarcoma, angiosarcoma, fibrosarcoma, MFH, chordoma, adamantinoma, and other sarcomas. *Excludes lymphoma of bone and multiple myeloma


Primary Tumor:

  • T1 - 8 cm or less in greatest dimension
  • T2 - >8 cm
  • T3 - discontinuous tumors in the primary bone site

Regional Lymph Nodes:

  • N0 - no
  • N1 - yes

Distant Metastases:

  • M0 - no
  • M1a - lung
  • M1b - other distant sites

Stage Grouping:

  • IA - T1 N0, Low grade
  • IB - T2 N0, Low grade; or T3 N0, Low grade
  • IIA - T1 N0, High grade
  • IIB - T2 N0, High grade
  • III - T3 N0, High grade
  • IVA - M1a
  • IVB - N1, M1b

Note: Ewing's sarcoma is classified as grade 4.

Change from AJCC 6th Edition:

  • T3 N0 Low Grade moved to IB (was Stage III for low or high grade)

AJCC Older Editions

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AJCC 6th Edition (2002)

  • No changes in TNM compared to 7th edition
  • Difference in stage grouping:

Stage Grouping:

  • IA - T1 N0, Low grade
  • IB - T2 N0, Low grade
  • IIA - T1 N0, High grade
  • IIB - T2 N0, High grade
  • III - T3 N0
  • IVA - M1a
  • IVB - N1, M1b


Musculoskeletal Tumor Society (MSTS) Staging

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  • IA - low grade, intracompartmental
  • IB - low grade, extracompartmental
  • IIA - high grade, intracompartmental
  • IIB - high grade, extracompartmental
  • III - regional or distant metastases
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