Ewing's sarcoma staging

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 sarcoma is classified accordig to AJCC staging system shown in table below.^[1]


Regional lymph nodes (N)
Primary tumor (T)
Stage	Finding
Stage	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 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	_
Stage	Finding
Nx	cannot be assessed
N0	No regional lymph node metastasis
N1	Regional lymph node metastasis
Distant metastasis (M)
Stage	Finding
M0	No distant metastasis
M1	Distant metastasis
M1a	Distant metastasis to lung
M1b	Distant metastasis to bone or other distant sites
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
IB	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
IVB	Any T	N1	M1b	Any G

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