Criteria

Musculoskeletal Tumor Society (MSTS) staging system[30]

The MSTS surgical staging system is frequently used for bone sarcomas and defines grades of nonmetastatic malignant bone tumors.

  • I-A: low-grade, intracompartmental

  • I-B: low-grade, extracompartmental

  • II-A: high-grade, intracompartmental

  • II-B: high-grade, extracompartmental

  • III: any grade, metastatic.

American Joint Committee on Cancer TNM staging system (8th Edition)[31]

The American Joint Committee on Cancer (AJCC) staging system describes the extent of disease based on the following anatomic factors: size and extent of the primary tumor (T); regional lymph node involvement (N); and presence or absence of distant metastases (M). Nonanatomic prognostic factors (e.g., tumor grade, biomarkers) may be used to supplement the staging of certain cancers.

National Comprehensive Cancer Network (NCCN)[23]

The NCCN practice guidelines describe 5 subtypes.

  • High-grade, intramedullary + surface

  • Low-grade, intramedullary + surface

  • Periosteal

  • Metastatic disease at presentation

  • Extraskeletal (see Soft-tissue sarcoma)

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