TNM staging system for rhabdomyosarcoma

Stage	Sites	Tumor stage invasiveness	T stage size	N	M
1	Orbit Head and neck^* Genitourinary^¶	T₁ or T₂	a or b	Any N	M₀
2	Bladder/prostate Extremity Cranial parameningeal Other^Δ	T₁ or T₂	a	N₀ or N_X	M₀
3	Bladder/prostate Extremity Cranial parameningeal Other^Δ	T₁ or T₂	a	N1	M₀
3	Bladder/prostate Extremity Cranial parameningeal Other^Δ	T₁ or T₂	b	Any N	M₀
4	All	T₁ or T₂	a or b	N₀ or N₁	M₁
T: Tumor stage		N: Regional nodes		M: Metastases
T₁: Confined to anatomic site of origin T₂: Extension a: ≤5 cm in diameter b: >5 cm in diameter		N₀: Not clinically involved N₁: Clinically involved N_X: Clinical status unknown		M₀: No distant metastases M₁: Distant metastases present (lung, bone, bone marrow, or presence of cells in cerebrospinal, pleural, or peritoneal fluid cytology)

* Excluding parameningeal.

¶ Nonbladder/nonprostate.

Δ Includes trunk, retroperitoneum, biliary tract, etc.

Adapted from:

Lawrence W, Gehan EA, Hays DM, et al. Prognostic significance of staging factors of the UICC staging system in childhood rhabdomyosarcoma: a report from the Intergroup Rhabdomyosarcoma Study (IRS-II). J Clin Oncol 1987; 5:46.
Lawrence W, Anderson JR, Gehan EA, et al. Pretreatment TNM staging of childhood rhabdomyosarcoma: a report of the Intergroup Rhabdomyosarcoma Study Group. Cancer 1997; 80:1165.
Meza JL, Anderson J, Pappo AS, et al. Analysis of prognostic factors in patients with nonmetastatic rhabdomyosarcoma treated on intergroup rhabdomyosarcoma studies III and IV: the Children's Oncology Group. J Clin Oncol 2006; 24:3844.

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