Surgical staging 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. The surgical staging of bone cancer is a comprehensive evaluation that combines surgical grade (grade, G), surgical territory (territory, T), and regional or distant metastasis (metastasis, M).

The surgical grading of bone cancer is determined by clinical manifestations, imaging characteristics, histology and examination, and can be divided into three levels: ①G0 histology shows benign cytology, good differentiation, X-ray shows that the tumor has clear boundaries, is confined to the cyst, has an intact capsule, and has no satellite lesions; ②G1 histology shows moderate cytology differentiation, X-ray shows that the tumor passes through the tumor capsule, and the destruction of the bone cortex may appear to grow outside the capsule. The clinical manifestations are slow growth, no skip metastasis, and occasional distant metastasis; ③G2 histology shows frequent nuclear divisions and poor differentiation. X-ray shows blurred edges and tumor spread to soft tissues. The clinical manifestations are rapid growth, skip metastasis, and frequent local or distant metastasis.

The surgical area T refers to the range of tumor infiltration, which is divided into intracapsular (T0), intracompartmental (T1) and extracompartmental (T2) tumors based on the tumor capsule and compartment. Intracompartmental bone cancer refers to cancer foci confined to a natural barrier, such as bone, fascia, periosteum, etc. Extracompartmental bone cancer refers to cancer foci that exceed the natural barrier due to tumor growth, fracture, surgical contamination, etc., and is invasive.

M stands for transfer, M0 represents no transfer, and M1 represents transfer.