Staging
Staging is a process that tells a doctor if the cancer has spread, and if it has, how far. Staging for osteosarcoma depends on the size, location, spread, and grade of the tumor. Tumor grade is a description of how the cancer cells look compared to normal cells under a microscope. Staging is an important step in evaluating prognosis and treatment options. When evaluating treatment options staging enables one institution to compare their treatment program with another hospital. Staging follows a broad criterion that includes tumor size, grade, lymph node spread and distant metastasis. Finally, staging also is used to establish eligibility for some clinical trials. Please refer to the AJCC staging manual for more detail.
Stage Ia
Click Image to Enlarge.
Description
- The tumor is low grade and no more than 8 cm in diameter. It has not spread outside of the bone to lymph nodes or other areas of the body.
Treatment
Stage Ib
Click Image to Enlarge.
Description
- The tumor is low grade and is either larger than or equal to 8 cm in diameter, or is in multiple locations on the same bone. It has not spread outside of the bone to lymph nodes or other areas.
Treatment
Stage IIa
Click Image to Enlarge.
Description
- The tumor is high grade and is 8 cm or less in diameter. It has not spread outside of the bone to lymph nodes or other areas of the body.
Treatment
- Chemotherapy, followed by surgery, followed by more chemotherapy.
Stage IIb
Click Image to Enlarge.
Description
- The tumor is high grade and more than 8 cm in diameter. It has not spread outside of the bone to lymph nodes or other areas of the body.
Treatment
- Chemotherapy, followed by surgery, followed by more chemotherapy.
Stage III
Click Image to Enlarge.
Description
- The tumor is high grade and is in multiple locations on the same bone. It has not spread outside of the bone to lymph nodes or other areas of the body.
Treatment
- Chemotherapy, followed by surgery, followed by more chemotherapy.
Stage IVa
Click Image to Enlarge.
Description
- The cancer has spread only to the lungs. The tumor may be any size and any grade.
Treatment
- Chemotherapy, possibly followed by surgery (if tumors are resectable), or radiation therapy (if non-resectable). Clinical trials may also be a good option.
Stage IVb
Click Image to Enlarge.
Description
- The cancer has spread to other distant sites besides the lung or in addition to the lung. The tumor may be any size, any grade, and may or may not have lymph node involvement.
Treatment
- Chemotherapy, possibly followed by surgery (if tumors are resectable), or radiation therapy (if non-resectable). Clinical trials may also be a good option.
In addition to the staging system described above, there is an alternative staging system used by the Musculoskeletal Society which is preferred by some clinicians.
