Ewing's sarcoma staging: Difference between revisions

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==Overview==
==Overview==
 
AJCC staging system is used for staging of Ewing's sarcoma.
==Ewing's sarcoma staging==
==Ewing's sarcoma staging==
*Ewing sarcoma is classified accordig to AJCC staging system shown in table below.<ref>{{cite book | last = Edge | first = Stephen | title = AJCC cancer staging manual | publisher = Springer | location = New York | year = 2010 | isbn = 978-0-387-88440-0 }}</ref>
{| class="wikitable"
{| class="wikitable"
|+
|+
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|-
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" |'''Finding'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
|-
|'''Spine'''
|style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Spine'''
|'''Pelvis'''
|style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Pelvis'''
|'''Appendicular skeleton, trunk, skull, and facial bones'''
|style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Appendicular skeleton, trunk, skull, and facial bones'''
|-
|-
|'''Tx'''
|'''Tx'''
|
|
* Cannot be assessed
* Cannot be assessed
|Cannot be assessed
|
|Cannot be assessed
* Cannot be assessed
|
* Cannot be assessed
|-
|-
| |'''T0'''
| |'''T0'''
|No evidence of primary tumor
|
|No evidence of primary tumor
* No evidence of primary [[tumor]]
|No evidence of primary tumor
|
* No evidence of primary [[tumor]]
|
* No evidence of primary [[tumor]]
|-
|-
!T1
|'''T1'''
!Confined to one vertebral segment or two adjacent vertebral segments
|
!Confined to one pelvic segment with no extraosseous extension
* Confined to one [[vertebral]] segment or two adjacent [[vertebral]] segments
|Tumor ≤8 cm in greatest dimension
|
 
* Confined to one [[pelvic]] segment with no extraosseous extension
|
* [[Tumor]] ≤8 cm in greatest dimension
*  
*  
|-
|-
!T2
|'''T2'''
!Confined to three adjacent vertebral segments
|
!Confined to one pelvic segment with extraosseous extension or two segments without extraosseous extension
* Confined to three adjacent [[vertebral]] segments
|Tumor >8 cm in greatest dimension
|
* Confined to one [[pelvic]] segment with extraosseous extension or two segments without extraosseous extension
|
* [[Tumor]] >8 cm in greatest dimension


*  
*  
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*  
*  
|-
|-
!T3
|'''T3'''
!Confined to four or more adjacent vertebral segments, or any nonadjacent vertebral segments
|
!Spanning two pelvic segments with extraosseous extension
* Confined to four or more adjacent [[vertebral]] segments, or any nonadjacent [[vertebral]] segments
|Discontinuous tumors in the primary bone site
|
* Spanning two [[pelvic]] segments with extraosseous extension
|
* Discontinuous [[tumors]] in the primary [[bone]] site


*  
*  
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*  
*  
|-
|-
!T4
|'''T4'''
!Extension into the spinal canal or great vessels
|
!Spanning three pelvic segments or crossing the sacroiliac joint
* Extension into the [[spinal canal]] or great [[vessels]]
|
* Spanning three [[pelvic]] segments or crossing the [[sacroiliac joint]]
|_
|_


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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" |'''Finding'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
|-
!Nx
!Nx
! colspan="3" |
| colspan="3" |
* cannot be assessed
* cannot be assessed


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|-
|-
!N0
!N0
! colspan="3" |
| colspan="3" |
* No regional lymph node metastasis
* No regional [[lymph node]] [[metastasis]]


*  
*  
|-
|-
!N1
!N1
! colspan="3" |
| colspan="3" |
* Regional lymph node metastasis
* Regional [[lymph node]] [[metastasis]]
|-
|-
|+
|+
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" |'''Finding'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
|-
!M0
!M0
! colspan="3" |
| colspan="3" |
* No distant metastasis
* No distant [[metastasis]]
 
*  
*  
|-
|-
!M1
!M1
! colspan="3" |
| colspan="3" |
* Distant metastasis
* Distant [[metastasis]]
 
*  
*  
*  
*  
|-
|-
!M1a
!M1a
! colspan="3" |
| colspan="3" |
* Distant metastasis to lung
* Distant [[metastasis]] to [[lung]]


*  
*  
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|-
|-
!M1b
!M1b
! colspan="3" |
| colspan="3" |
* Distant metastasis to bone or other distant sites
* Distant [[metastasis]] to [[bone]] or other distant sites


*
*
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*  
*  
|-
|-
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Histologic grade (G)'''
| colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Histologic grade (G)'''
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" |'''Finding'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
|-
!Gx
!Gx
! colspan="3" |
| colspan="3" |
* cannot be assessed
* cannot be assessed


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|-
|-
!G1
!G1
! colspan="3" |
| colspan="3" |
* Low grade
* Low grade
*  
*  
|-
|-
!G2
!G2
! colspan="3" |
| colspan="3" |
* High grade (moderately differentiated)
* High grade (moderately differentiated)


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|-
|-
!G3
!G3
! colspan="3" |
| colspan="3" |
* High grade (poorly differentiated)
* High grade (poorly differentiated)
|-
|-
!G4
| colspan="3" |
* Undifferentiated
|-
|-
|}
|}


{| style="border: 0px; font-size: 90%; margin: 3px;" align=center
|+'''''Anatomic Stage/Prognostic Groups'''''
! style="background: #4479BA; width: 120px;" | {{fontcolor|#FFF|Stage}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|T}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|N}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|M}}
! style="background: #4479BA; width: 550px;" | {{fontcolor|#FFF|G}}
|-
| colspan="5" style="padding: 5px 5px; background: #DCDCDC;font-weight: bold" align="center" | '''Ewing's Sarcoma'''
|-
! style="background: #DCDCDC;" |IA
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |G1,2, GX
|-
! rowspan="2" style="background: #DCDCDC;" |IB
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |G1,2, GX
|-
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |G1,2, Gx
|-
! style="background: #DCDCDC;" |IIA
! style="background: #F5F5F5;" |T1
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |G3,4
|-
! style="background: #DCDCDC;" |IIB
! style="background: #F5F5F5;" |T2
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |G3, 4
|-
! style="background: #DCDCDC;" |III
! style="background: #F5F5F5;" |T3
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M0
! style="background: #F5F5F5;" |G3,4
|-
! style="background: #DCDCDC;" |IVA
! style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |N0
! style="background: #F5F5F5;" |M1a
! style="background: #F5F5F5;" |Any G
|-
! rowspan="2" style="background: #DCDCDC;" |IVB
! rowspan="2" style="background: #F5F5F5;" |Any T
! style="background: #F5F5F5;" |Any N
! style="background: #F5F5F5;" |Any M
! style="background: #F5F5F5;" |Any G
|-
! style="background: #F5F5F5;" |N1
! style="background: #F5F5F5;" |M1b
! style="background: #F5F5F5;" |Any G
|}
==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Latest revision as of 14:55, 28 October 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2];Assistant Editor(s)-In-Chief: Michael Maddaleni, B.S.

Overview

AJCC staging system is used for staging of Ewing's sarcoma.

Ewing's sarcoma staging

  • Ewing sarcoma is classified accordig to AJCC staging system shown in table below.[1]
Primary tumor (T)
Stage Finding
Spine Pelvis Appendicular skeleton, trunk, skull, and facial bones
Tx
  • Cannot be assessed
  • Cannot be assessed
  • Cannot be assessed
T0
  • No evidence of primary tumor
  • No evidence of primary tumor
  • No evidence of primary tumor
T1
  • Confined to one pelvic segment with no extraosseous extension
  • Tumor ≤8 cm in greatest dimension
T2
  • Confined to three adjacent vertebral segments
  • Confined to one pelvic segment with extraosseous extension or two segments without extraosseous extension
  • Tumor >8 cm in greatest dimension
T3
  • Confined to four or more adjacent vertebral segments, or any nonadjacent vertebral segments
  • Spanning two pelvic segments with extraosseous extension
T4 _
Regional lymph nodes (N)
Stage Finding
Nx
  • cannot be assessed
N0
N1
Distant metastasis (M)
Stage Finding
M0
M1
M1a
M1b
Histologic grade (G)
Stage Finding
Gx
  • cannot be assessed
G1
  • Low grade
G2
  • High grade (moderately differentiated)
G3
  • High grade (poorly differentiated)
G4
  • Undifferentiated
Anatomic Stage/Prognostic Groups
Stage T N M G
Ewing's Sarcoma
IA T1 N0 M0 G1,2, GX
IB T2 N0 M0 G1,2, GX
T3 N0 M0 G1,2, Gx
IIA T1 N0 M0 G3,4
IIB T2 N0 M0 G3, 4
III T3 N0 M0 G3,4
IVA Any T N0 M1a Any G
IVB Any T Any N Any M Any G
N1 M1b Any G

References

  1. ↑ Edge, Stephen (2010). AJCC cancer staging manual. New York: Springer. ISBN 978-0-387-88440-0.


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