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The information on this page was reviewed and approved by
Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on July 16, 2021.

Bone cancer stages

The staging guidelines developed by the American Joint Committee on Cancer (AJCC) are often used to stage bone cancers and allow doctors to communicate important information about the cancer with each other in a standardized way. Bone cancer stages are based on four categories:

T (tumor): This describes the size of the original tumor.

N (node): This indicates whether the cancer is present in the lymph nodes.

M (metastasis): This refers to whether cancer has spread to other parts of the body.

After the TNM score is assigned, bone cancer will be classified into one of the stages below:

Stage 1 bone cancer: The cancer cells are still localized to the bone, and the tumor is considered low-grade. Stage 1 bone cancer is divided into two subcategories:

  • Stage 1A: These cancers are less than 8 cm in size.
  • Stage 1B: The tumor is larger than 8 cm or can be found in several places in the same bone.

Stage 2 bone cancer: These cancers are still localized to the bone, but they are considered high-grade. Stage 2 bone cancer is divided into two subcategories:

  • Stage 2A: The tumor is less than 8 cm.
  • Stage 2B: The tumor is larger than 8 cm.

Stage 3 bone cancer: Primary bone cancers at this stage are still localized to the bone, but they are high-grade and have spread to several places within the same bone.

Stage 4 bone cancer: Stage 4 bone cancer is the most advanced form of the disease. In stage 4, the cancer has spread beyond the bone to other areas of the body. For bone cancer, staging also takes into account how abnormal the cells look under the microscope (the grade). Stage 4 bone cancer can be any Tor N, meaning the tumor may be any size and may have grown into the lymph nodes. The cancer may be categorized as stage 4A or 4B:

  • Stage 4A: The cancer has also spread to the lung(s).
  • Stage 4B: The cancer has spread to the lymph nodes, or the tumor is of any size and grade and has spread to another organ besides the lung. Bone cancer experts typically classify bone cancer stages into localized and metastatic. Stage 4 bone cancer is the same as metastatic cancer.

Learn more about orthopedic oncology

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