07 February 2022, Monday

Bone Cancer Grading



‘Grade’ of the tumor is a histological calculation of the aggressiveness of a malignant tumor (more specifically, its ability to metastasize, i.e. the ability to spread to other regions of the body).

Grading of the tumor is done by the pathologist based on the histological observations made on the tumor tissue. This information tells the clinician about the extent of risk, the patient has, of developing metastasis. There are several different systems for grading a malignant tumor.

In simple words, staging is a system to determine the extent of cancer in the patient and the level of risk posed to the patient due to it. Stage of the cancer at diagnosis, is the best predictor of survival and is a powerful guide to the optimal treatment of the disease.

In cancer management, after a diagnosis of cancer is made, a set of tests are carried out to stage the cancer. Staging may involve several investigations like histopathology, MRI, CT scan, Bone scan, PET scan, etc.

The exact set of investigations varies from case to case and will be decided by your treating doctor. Staging criteria may differ slightly for different tumors. One of the most important pieces of information derived from staging investigations is whether the disease is localized or metastatic.

It is possible that the patient may have the disease in other parts of the body, but is not aware of it as they are small in size and therefore, are not causing any problem at this moment. Staging investigations help in locating and identifying these metastatic foci of disease early.

This helps in choosing the most useful and effective treatment approach to such a patient, giving due consideration to the presence of any metastasis and its treatment. The importance of staging is that, treatment strategies can be specifically planned to the patient’s situation, based on the stage of the disease, to get the best outcome.

For bone sarcomas, there are two major staging systems. One is the MSTS (Musculoskeletal Tumor Society) staging system, which classifies these conditions into three stages, with stage ‘I’ being the lowest, offering the best prognosis to the patient and stage ‘III’ representing the highest, indicating metastatic disease and consequent poor prognosis.

The other staging system is the AJCC (American Joint Committee on Cancer) staging system (also called the TNM System) which classifies these diseases into four stages with stage ‘I’ being the lowest, offering the best prospect for recovery and stage ‘IV’ denoting the highest, indicating metastatic disease, suggesting the least chance of a least favourable outcome.

Further Reads:

What is the difference between ‘Grade’ of the disease and ‘Stage’ of the disease?


    Dr. Chetan Anchan

    MS - Orthopaedics, Diploma in Orthopaedics,

    FCPS - Mid. & Gynae, MBBS

    About Author - Dr. Chetan Anchan is an expert and well known orthopaedic surgeon and oncologist from Mumbai. He has a vast experience in treating all types of Malignant and Benign, Bone and Soft Tissue Tumors, and Skeletal Metastases.

    To book an appointment, call: +91 – 93244 27302

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