Your guide to the Enneking system which helps your surgeon decide about treatment for cancer that starts in your bone (primary bone cancer). A System for the Surgical Staging of. Musculoskeletal Sarcoma. WILLIAM. F. ENNEKING,. M.D.,* SUZANNE. S. SPANIER,. M.D.,** AND. MARK A. GOODMAN, . Based on a combination of histologic grade (G), anatomic site (T), and presence or absence of distant metastasis (M) Grade G0 = benign G1 = low grade.

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Metastatic bone cancer has spread to other parts of the body farther from the original tumour. This places the patient at greater risk of local recurrence and metastasis. This includes axial imaging to determine the anatomic confines of the primary tumor and the presence of metastasis.

Enneking staging system

The most common place for bone cancer to spread to is the lungs. A system for the surgical staging of musculoskeletal sarcoma. The probability of survival as a function of stage for intracompartmental and extracompartmental groups was similar [ 5 ]. If we are not able to reach you by phone, we will leave a voicemail message. Learn how your comment data is processed.

L8 – 10 enneklng in practice. Ideally, a combination of the staging systems may provide a stronger instrument than either alone. This system was established initially at the University of Florida in based on the data collected from through by Dr. Many factors are involved in choosing the proper therapy for the patients. Anatomic compartments have inherent barriers to tumor spread, including fascial planes and bone structures.


Historically, surgical resection has been the cornerstone for management of musculoskeletal sarcomas. It has been used widely for classification by orthopaedic oncologic surgeons around the world. Your doctors might use the Enneking staging system or another staging system called TNM.

G3 and G4 size T1: They usually are not amenable to limb salvage operations and require radical amputation or disarticulation. In addition to the histologic features, the staging takes into account the clinical and radiographic features.

Lesions originating in the skull also behave differently and thus cannot be staged or classified using this system. Viswanathan S, Jambhekar NA. Radiol Clin North Am.

Each lesion ultimately is assessed on histologic features; however, some ennwking are high grade by definition, such as a dedifferentiated chondrosarcoma [ 3 ]. The Enneking surgical staging has been validated in two distinct situations: The stage of the tumor dictates the extent of surgical resection and margin.

A systematic meta-analysis of randomized controlled trials of adjuvant chemotherapy for localized resectable soft-tissue sarcoma. This site uses Akismet to reduce spam. Thus the most useful staging system would guide the nature of the surgical procedure.

Stage 2A The cancer is high grade and is only inside the bone. Purpose An ideal staging system should be practical, reproducible, and of prognostic significance. Well-demarcated borders Grows slowly and stops Heals spontaneously [ osteoid osteoma ] Negligible recurrence after intracapsular resection.

Anatomical compartments have natural barriers, e. The classification is based on radiographic characteristics of the tumor host margin. It groups bone enneking as localized and metastatic.

These tumors are characterized by low mitotic rates, low nuclear to cytoplasmic ennekign, and limited pleomorphism. Larger lesions may be more likely to metastasize and may benefit from adjuvant chemotherapy [ 10 ].

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Staging childhood bone cancer

G1 and G2 high grade: Throughout the body, there are many soft tissue compartments, e. Joints are also compartments with their surgical boundaries being the articular cartilage and the joint capsule.

Doctors often use a simple system to stage childhood bone cancer. Enneking Staging System and TGNM staging system are two main staging systems used for staging for benign and malignant enbeking of the musculoskeletal system.

Cancer staging is deemed critical for disease control in an individual patient and for the ennekinh at large.

Arun Pal Singh is an orthopedic and trauma surgeon, founder and chief editor of this website. Work-up is negative for metastasis, but biopsy reveals a high grade lesion.

Stage III represents any tumor with distant metastasis.

What is the stage of this tumor by the Musculoskeletal Tumor Society system? Please vote below and help us build the most advanced adaptive learning platform in medicine The complexity of this topic is appropriate for? The adequacy of the surgical margin is determined by whether stagibg not there is a barrier between the plane or resection and the tumor. The Enneking surgical staging system is based on the natural evolution of mesenchymal tumors and thus is not applicable stagibg tumors originating in either the marrow or reticuloendothelial system.