Biopsy is needed to establish the diagnosis for primary - but not for metastatic sites (masses seen in liver or lung) except for bone marrow.
Staging prior to treatment requires:
- Clinical examination
- Imaging studies
Pre-treatment size is part of the staging:
- Measured on MRI or CT depending on location.
- Examination and CT can be used to assess lymph size.
- Metastatic sites will require some form.
Primary Tumor: TNM Staging of Rhabdomyosarcoma
T1 = Confined to anatomic site of origin
- a. ≤ 5 cm in diameter in size
- b. > 5 cm in diameter in size
T2 = Extension and/or fixative to surrounding tissue
- a. ≤ 5 cm in diameter in size
- b. > 5 cm in diameter in size.
Regional Nodes
- N0 = Regional nodes not clinically involved
- N1 = Regional nodes clinically involved by neoplasm
- Nx = Clinical status of regional nodes unknown (especially sites where lymph node evaluation is not possible.
Metastasis
- M0 = No distant metastasis
- M1 = Distant metastasis present
TNM Staging depends on the tumor SITE.
Stage 1
Sites (favorable)
- Head and neck (excluding parameningeal)
- Orbit
- Genitourinary (non-bladder/non-prostate)
- Biliary Tract
IN ADDITION THESE TUMORS MUST ALSO BE T1 or T2 (a or b), N0/1/x and M0
Stage 2
Sites:
- Bladder / prostate
- Extremity
- Cranial parameningeal
- Other: trunk, retroperitoneum, etc
IN ADDITION THESE TUMORS MUST ALSO BE T1 or T2 a (not b), N0 or Nx (not N1) and M0
Stage 3
Sites:
- Bladder/Prostate
- Cranial parameningeal
- Other: trunk, retroperitoneum, etc
IN ADDITION THESE TUMORS MUST ALSO BE:
- T1 or T2
- If a (≤5cm) then also N1
- If b (>5cm) then any nodal status (N0/1/x)
- M0
Stage 4
- All sites
THESE TUMORS ARE M1 (distant metastases) with either T1 or 2, a or b and any nodal status (N0/1/x)
TNM Staging Summary:
| Stage 1 |
T1 or T2 (a or b) N0 or N1 or Nx M0 |
|
| Stage 2 |
T1 or T2a N0 or Nx M0 |
|
| Stage 3 |
T1 or T2 a N1 M0
T1 or T2b N0 or N1 or Nx M0 |
|
| Stage 4 |
T1 or T2 a or b N0 or N1 M1 |
|
External link:
RMS staging at the National Cancer Institute
