Radiation Oncology/Bone/Background
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[edit] Epidemiology
Incidence: 8 per 1,000,000.
2440 cases in 2004.
Incidence: osteosarcoma (35%), chondrosarcoma (30%), Ewing's sarcoma (16%)
[edit] Staging
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.
AJCC 7th Edition (2009)
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)
[edit] Older staging editions
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
