Staging of Malignant Tumours - Callum Clark 16/5/2002

Important for:

Evaluation

Planning treatment

Prognosis

Musculoskeletal Tumour Society Surgical Staging System (1980) / Enneking System

2 systems:

Benign

Malignant:

Surgical Grade (=clinical factors+histology)

G1 = Low grade (potential for mets < 25%)

G2 = High grade (potential for mets > 25%)

Surgical Site:

T1 = intracompartmental

T2 = extracompartmental

Metastases (or regional lymphatic spread)

M0 = none

M1 = mets

GTM used to create six stages:

1a G1 T1 M0

1b G1 T2 M0

2a G2 T1 M0

2b G2 T2 M0

3a G1or2 T1 M1

3b G1or2 T2 M1

The Staging Process

(Biopsy = last if clinically aggressive tumour)

1/ History/Examination-

5 primary sites + liver mets

2/ Radiology:

Radiographs in 2 planes —

"Enneking's 4 questions"

Abdo Ultrasound

Bone Scan —

Monostotic vs Polyostotic

1.6% of malig. Bone tumours metastasise to bone

Multiple Myeloma

CT-

Anatomic site and extent (including soft tissue)

MRI-

Cannot delineate between benign and low-grade malignant

Angiography-

Tumour extent

Planning arterial chemotherapy

Embolisation

Planning limb salvage

CXR

3/ Laboratory studies:

Bloods- FBC, ESR, Bone, LFT, Acid Phos, PSA, TFT, serum electrophoresis

Urine- Bence Jones Proteins

4/ Biopsy:

Should be performed by the surgeon who will perform the tumour resection

(Musculoskeletal Tumour Society)



Please log in to view the content of this page.
If you are having problems logging in, please refer to the login help page.


© 2011 Orthoteers.co.uk Website by Regency Medical Marketing 
Biomet supporting orthoteersOrthoteers is a non-profit educational resource. Click here for more details
Hindquarter Amputation - Ian Hollow...
Paediatric Bone Tumours: Salvage vs...
Staging of Malignant Tumours - Call...
OWLS Advertise on Orthoteers
Orthoteers Junior Orthoteers Orthopaedic Biomechanics Orthopaedic World Literature Society Educational Resources Image Gallery About Orthoteers Orthoteers Members search
Hide Menu