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Part of Cancer staging guidance sheets

Bone (ICD10 C40 & C41)

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Current chapter – Bone (ICD10 C40 & C41)


Introduction

This is the data sheet for TNM 8th edition staging of the bone (ICD10 C40 & C41)

For more detailed information regarding TNM staging, please see pages 120-123 of the UICC TNM 8 book or visit the Wiley and UICC website.


Stage groupings

Appendicular Skeleton, Trunk, Skull and Facial Bones

Stage Group

T stage

N stage

M stage

Grade

Stage IA

T1

N0

M0

G1, GX Low Grade

Stage IB

T2, T3

N0

M0

G1, GX Low Grade

Stage IIA

T1

N0

M0

G2, G3 High Grade

Stage IIB

T2

N0

M0

G2, G3 High Grade

Stage III

T3

N0

M0

G2, G3 High Grade

Stage IVA

Any T

N0

M1a

Any G

Stage IVB

Any T

N1

Any M

Any G

Stage IVB

Any T

Any N

M1b

Any G

Spine and Pelvis

There is no stage for bone sarcomas of the spine or pelvis.


TNM clinical classification

T - primary tumour

T value Description

TX

Primary tumour cannot be assessed

T0

No evidence of primary tumour

Appendicular Skeleton, Trunk, Skull and Facial Bones

T1

Tumour 8 cm or less in greatest dimension

T2

Tumour more than 8 cm in greatest dimension

T3

Discontinuous tumours in the primary bone site

Spine

T value Description

T1

Tumour confined to a single vertebral segment or two adjacent vertebral segments

T2

Tumour confined to three adjacent vertebral segments

T3

Tumour confined to four adjacent vertebral segments

T4a

Tumour invades into the spinal canal

T4b

Tumour invades the adjacent vessels or tumour thrombosis within the adjacent vessels

Note:

The five vertebral segments are the: Right pedicle, Right body, Left body, Left pedicle, Posterior element

Pelvis

T value Description

T1a

A tumour 8 cm or less in size and confined to a single pelvic segment with no extraosseous extension

T1b

A tumour greater than 8 cm in size and confined to a single pelvic segment with no extraosseous extension

T2a

A tumour 8 cm or less in size and confined to a single pelvic segment with extraosseous extension or confined to two adjacent pelvic segments without extraosseous extension

T2b

A tumour greater than 8 cm in size and confined to a single pelvic segment with extraosseous extension or confined to two adjacent pelvic segments without extraosseous extension

T3a

A tumour 8 cm or less in size and confined to two pelvic segments with extraosseous extension

T3b

A tumour greater than 8 cm in size and confined to two pelvic segment with extraosseous extension

T4a

Tumour involving three adjacent pelvic segments or crossing the sacroiliac joint to the sacral neuroforamen

T4b

Tumour encasing the external iliac vessels or gross tumour thrombus in major pelvic vessels

Note:

The four pelvic segments are the: Sacrum lateral to the sacral foramen; Iliac wing; Acetabulum/periacetabulum and Pelvic rami; symphysis and ischium

N - regional lymph nodes

N value Description

NX

Regional lymph nodes cannot be assessed

N0

No regional lymph node metastasis

N1

Regional lymph node metastasis

M - distant metastasis

M value Description

M0

No distant metastasis

M1

Distant metastasis

M1a - Lung

M1b - Other distant sites


TNM pathological classification

pT - primary tumour

The pT and pN categories correspond to the T and N categories as per above.


Download

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Last edited: 20 December 2022 10:39 am

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