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Staging (Bone)
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Staging (Bone)
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Pathologic Staging (pTNM)
CAP Approved Other • Bone 4.0.0.0
TNM Descriptors (required only if applicable) (select all that apply)
___ m (multiple)
___ r (recurrent)
___ y (posttreatment)
Primary Tumor (pT)
Appendicular Skeleton, Trunk, Skull, and Facial Bones
___ pTX: Primary tumor cannot be assessed
___ pT0: No evidence of primary tumor
___ pT1: Tumor ≤8 cm in greatest dimension
___ pT2: Tumor > 8 cm in greatest dimension
___ pT3: Discontinuous tumors in the primary bone site
Spine
___ pTX: Primary tumor cannot be assessed
___ pT0: No evidence of primary tumor
___ pT1: Tumor confined to one vertebral segment or two adjacent vertebral segments
___ pT2: Tumor confined to three adjacent vertebral segments
___ pT3: Tumor confined to four or more adjacent vertebral segments, or any nonadjacent vertebral segments
___ pT4: Extension into the spinal canal or great vessels
___ pT4a: Extension into the spinal canal
___ pT4b: Evidence of gross vascular invasion or tumor thrombus in the great vessels
Pelvis
___ pTX: Primary tumor cannot be assessed
___ pT0: No evidence of primary tumor
___ pT1: Tumor confined to one pelvic segment with no extraosseous extension
___ pT1a: Tumor ≤8 cm in greatest dimension
___ pT1b: Tumor >8 cm in greatest dimension
___ pT2: Tumor confined to one pelvic segment with extraosseous extension or two segments without extraosseous extension
___ pT2a: Tumor ≤8 cm in greatest dimension
___ pT2b: Tumor >8 cm in greatest dimension
___ pT3: Tumor spanning two pelvic segments with extraosseous extension
___ pT3a: Tumor ≤8 cm in greatest dimension
___ pT3b: Tumor >8 cm in greatest dimension
___ pT4: Tumor spanning three pelvic segments or crossing the sacroiliac joint
___ pT4a: Tumor involves sacroiliac joint and extends medial to the sacral neuroforamen
___ pT4b: Tumor encasement of external iliac vessels or presence of gross tumor thrombus in major pelvic vessels
Regional Lymph Nodes (pN)
___ pNX: Regional lymph nodes cannot be assessed#
___ pN0: No regional lymph node metastasis
___ pN1: Regional lymph node metastasis
# Note: Because of the rarity of lymph node involvement in bone sarcomas, the designation NX may not be appropriate, and cases should be considered N0 unless clinical node involvement clearly is evident.
Distant Metastasis (pM) (required only if confirmed pathologically in this case)
___ pM1a: Lung
___ pM1b: Metastasis involving distant sites other than lung
Specify site(s), if known: ____________________________
Summary of changes AJCC 7th to 8th ed.