Part of Cancer staging guidance sheets
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.
Last edited: 20 December 2022 10:39 am