Part of Cancer staging guidance sheets
Bone (ICD10 C40, C41)
Introduction
This is the data sheet for TNM 9th edition staging of the bone (ICD10 C40 & C41)
For more detailed information regarding TNM staging, please see pages 122-125 of the UICC TNM 9 book.
Stage groupings
Appendicular Skeleton, Trunk, Skull and Facial Bones
|
Stage Group |
T stage |
N stage |
M stage |
|
|---|---|---|---|---|
|
Stage IA |
T1 |
N0 |
M0 |
G1, GX Low Grade |
|
Stage IB |
T2, T3 |
N0 |
M0 |
G1, GX Low Grade |
|
Stage IIA |
T1 |
N0 |
M0 |
G2, G3 High Grade |
|
Stage IIB |
T2 |
N0 |
M0 |
G2, G3 High Grade |
|
Stage III |
T3 |
N0 |
M0 |
G2, G3 High Grade |
|
Stage IVA |
Any T |
N0 |
M1a |
Any G |
|
Stage IVB |
Any T |
N1 |
Any M |
Any G |
|
|
Any T |
Any N |
M1b |
Any G |
Spine and Pelvis
There is no stage for bone sarcomas of the spine or pelvis.
TNM clinical classification
T - primary tumour
|
T value |
Description |
|---|---|
|
cTX |
Primary tumour cannot be assessed |
|
cT0 |
No evidence of primary tumour |
Appendicular Skeleton, Trunk, Skull and Facial Bones
|
T value |
Description |
|---|---|
|
cT1 |
Tumour 8 cm or less in greatest dimension |
|
cT2 |
Tumour more than 8 cm in greatest dimension |
|
cT3 |
Discontinuous tumours in the primary bone site |
Spine
|
T value |
Description |
|---|---|
|
cT1 |
Tumour confined to a single vertebral segment or two adjacent vertebral segments |
|
cT2 |
Tumour confined to three adjacent vertebral segments |
|
cT3 |
Tumour confined to four adjacent vertebral segments |
|
cT4a |
Tumour invades into the spinal canal |
|
cT4b |
Tumour invades the adjacenet vessels or tumour thrombosis within the adjacent vessels |
Note:
The five vertebral segments are the: Right pedicle, Right body, Left body, Left pedicle, Posterior element
Pelvis
|
T value |
Description |
|---|---|
|
cT1a |
A tumour 8 cm or less in size and confined to a single pelvic segment with no extraosseous extension |
|
cT1b |
A tumour greater than 8 cm in size and confined to a single pelvic segment with no extraosseous extension |
|
cT2a |
A tumour 8 cm or less in size and confined to a single pelvic segment with extraosseous extension or confined to two adjacent pelvic segments without extraosseous extension |
|
cT2b |
A tumour greater than 8 cm in size and confined to a single pelvic segment with extraosseous extension or confined to two adjacent pelvic segments without extraosseous extension |
|
cT3a |
A tumour 8 cm or less in size and confined to two pelvic segments with extraosseous extension |
|
cT3b |
A tumour greater than 8 cm in size and confined to two pelvic segment with extraosseous extension |
|
cT4a |
Tumour involving three adjacent pelvic segments or crossing the sacroiliac joint to the sacral neuroforamen |
|
cT4b |
Tumour encasing the external iliac vessels or gross tumour thrombus in major pelvic vessels |
Note:
The four pelvic segments are the: Sacrum lateral to the sacral foramen; Iliac wing; Acetabulum/periacetabulum; Pelvic rami, symphysis and ischium
N - regional lymph nodes
|
N value |
Description |
|---|---|
|
cNX |
Regional lymph nodes cannot be assessed |
|
cN0 |
No regional lymph node metastasis |
|
cN1 |
Regional lymph node metastasis |
M - distant metastasis
|
M value |
Description |
|---|---|
|
cM0 |
No distant metastasis |
|
cM1 |
Distant metastasis cM1a - Lung cM1b - Other distant sites |
TNM pathological classification
pT - primary tumour
The pT and pN categories correspond to the cT and cN categories as per above.
Last edited: 16 January 2026 3:48 pm
