Ewing's sarcoma staging: Difference between revisions

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__NOTOC__
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{{Ewing's sarcoma}}
{{Ewing's sarcoma}}
{{CMG}};{{AE}} {{PSK}};'''Assistant Editor(s)-In-Chief:''' {{MJM}}


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==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.<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"
|+
| colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" ! + |'''Primary tumor (T)'''
|-
| rowspan="2" style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
|style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Spine'''
|style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Pelvis'''
|style="background: #DCDCDC; padding: 5px; text-align: left;" |'''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 [[vertebral]] segment or two adjacent [[vertebral]] segments
|
* 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
|
* Discontinuous [[tumors]] in the primary [[bone]] site
 
*
 
*
|-
|'''T4'''
|
* Extension into the [[spinal canal]] or great [[vessels]]
|
* Spanning three [[pelvic]] segments or crossing the [[sacroiliac joint]]
|_
 
*
*
|-
|+
 
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Regional lymph nodes (N)'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
!Nx
| colspan="3" |
* cannot be assessed
 
*
|-
!N0
| colspan="3" |
* No regional [[lymph node]] [[metastasis]]
 
*
|-
!N1
| colspan="3" |
* Regional [[lymph node]] [[metastasis]]
|-
|+
 
! colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Distant metastasis (M)
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
!M0
| colspan="3" |
* No distant [[metastasis]]
*
|-
!M1
| colspan="3" |
* Distant [[metastasis]]
*
*
|-
!M1a
| colspan="3" |
* Distant [[metastasis]] to [[lung]]
 
*
*
|-
!M1b
| colspan="3" |
* Distant [[metastasis]] to [[bone]] or other distant sites
 
*
 
*
|-
| colspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |'''Histologic grade (G)'''
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Stage'''
| colspan="3" style="background: #DCDCDC; padding: 5px; text-align: left;" |'''Finding'''
|-
!Gx
| colspan="3" |
* cannot be assessed
 
*
|-
!G1
| colspan="3" |
* Low grade
*
|-
!G2
| colspan="3" |
* High grade (moderately differentiated)
 
*
|-
!G3
| colspan="3" |
* 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


{{CMG}}
! style="background: #F5F5F5;" |M0
{{MJM}}
! style="background: #F5F5F5;" |G1,2, GX
|-
! rowspan="2" style="background: #DCDCDC;" |IB
! style="background: #F5F5F5;" |T2


==Overview==
! style="background: #F5F5F5;" |N0
Staging for cancers in general follows as similar pattern. There are stages I - IV and there are subsections of each stage. Staging for specific cancers have specific staging criteria.


==Ewing's sarcoma staging==
! style="background: #F5F5F5;" |M0
*Stage II - high grade [[lesions]], such as Ewing's sarcomas<ref name="pmid17272319">{{cite journal |author=Iwamoto Y |title=Diagnosis and treatment of Ewing's sarcoma |journal=[[Japanese Journal of Clinical Oncology]] |volume=37 |issue=2 |pages=79–89 |year=2007 |month=February |pmid=17272319 |doi=10.1093/jjco/hyl142 |url=http://jjco.oxfordjournals.org/cgi/pmidlookup?view=long&pmid=17272319 |accessdate=2011-12-23}}</ref>
! style="background: #F5F5F5;" |G1,2, GX
**Stage IIA - Lesions that are self contained in a well defined anatomical compartment
|-
**Stage IIB - Lesions that extend beyond their initial compartment
! style="background: #F5F5F5;" |T3
*Stage III - This includes any lesion that has [[metastasized]] regardless of its size. When discovered, most Ewing's sarcoma lesions fall into the stage II or stage III categories.
! 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
|-


While staging tests are being performed, a [[CT scan]] of the chest should be completed. This will help determine if the cancer has metastasized to the lungs of the patient.
! 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}}
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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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