2010NCCN美國骨腫瘤指南
《2010NCCN美國骨腫瘤指南》內容簡介：
The 2002 American Joint Committee on Cancer （AJCC） TNM stagingclassification is shown in Table 1. This system is based on assessmentof histologic grade （G）， tumor size （T）， presence of regional- （N） and/ordistant metastases （M）。 The Surgical Staging System （SSS） is anotherstaging system for bone and soft-tissue sarcomas developed by theMusculoskeletal Tumor Society （Table 2）。24This system stratifies bothbone and soft-tissue lesions by assessment of the surgical grade （G），the local extent （T）， and the presence or absence of regional or distantmetastases. It may be used in addition to the AJCC staging system.
《2010NCCN美國骨腫瘤指南》內容預覽：
Diagnostic Workup
Suspicion of a malignant bone tumor often begins when a poorlymarginated lesion is seen on a plain radiograph in a patient with apainful lesion. In patients under 40, an aggressive, painful bone lesionhas a significant risk of being a malignant primary bone tumor, andreferral to an orthopedic oncologist should be considered prior to furtherwork-up. In patients 40 and over, if plain films and history do notsuggest a specific diagnosis, evaluation for a metastatic carcinoma,including chest radiograph, computed tomography （CT） of the chest,abdominal and pelvic, bone scan, mammogram, and other imagingstudies as clinically indicated, should be performed.
All patients with suspected bone sarcoma should undergo completestaging prior to biopsy. The standard staging work-up for a suspectedprimary bone sarcoma should include imaging of the chest （chestradiograph or chest CT to detect pulmonary metastases）， appropriateimaging of the primary site [plain radiographs, magnetic resonanceimaging （MRI） for local staging and/or CT scan] and bone scan.
Imaging of painless bone lesions should be evaluated by amusculoskeletal radiologist followed by appropriate referral to amultidisciplinary treatment team if necessary. Laboratory studies, suchas **, lactate dehydrogenase （LDH）， alkaline phosphatase （ALP）should be done prior to initiation of treatment.
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