Surgical staging and treatment of bone cancer

The pathological grading of bone cancer reflects the biological behavior and invasiveness of the tumor. Using surgical staging to guide the treatment of bone cancer has been recognized as a reasonable and effective measure. Surgical staging is a comprehensive evaluation that combines surgical grading (G), surgical region (T), and regional or distant metastasis (M).

G1 represents low-grade malignancy, G2 represents high-grade malignancy; T0 represents the tumor is confined to the tumor capsule, T1 represents the tumor is confined to the compartment, and T2 represents the tumor breaks through the natural barrier and grows aggressively; M0 represents no metastasis, and M1 represents metastasis.

The treatment of bone cancer is based on surgical staging. The surgical boundaries and methods should be selected according to the surgical staging to achieve both tumor removal and limb preservation. Stage IA refers to G1T1M0, which can be treated with local wide resection and limb preservation; stage IB refers to G1T2M0, which can be treated with wide resection and amputation; stage IIA refers to G2T1MO, which requires radical en bloc resection plus other treatments; stage IIB refers to G2T2MO, which requires radical amputation plus other treatments; stage IIIA refers to G1-2T1M1, which requires radical resection or palliative surgery plus other treatments, and removal of lung metastases; stage IIIB refers to G1-2T2M1, which requires radical relief or palliative surgery plus other treatments, and removal of lung metastases.