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A woman talking to her doctor about spinal tumor stages

Spinal cancer stages and grades are based on a standardized system that can be useful for medical professionals when discussing the aggressiveness and extent of a cancer’s spread beyond its site of origin. Both primary and metastatic spinal tumors can be staged and graded; whereas, spinal cord tumors are typically only graded as they rarely spread to other parts of the body. Along with many other factors, this information is considered when determining the most appropriate course of treatment for a patient.

Grading is a system developed by the World Health Organization to help determine how best to treat spinal cancers. This technique examines the features of the tumor under the microscope.

Tumors that develop within the spinal anatomy differ from those that originate in other areas of the body in several key respects. For instance, primary spinal tumors rarely spread beyond the spine and central nervous system. Therefore, while other cancers are usually classified by stages, there are no formal spinal cancer stages. Instead, primary spinal cancer is usually assigned a grade based on the characteristics of the tumor as follows:

  • Grade I – The tumor shows benign features and is slow-growing. These tumors are unlikely to spread to nearby tissue and may be removed completely through surgery.
  • Grade II – The tumor appears to be slow-growing, but some cells can appear abnormal and have the potential to spread to nearby tissue or recur after removal.
  • Grade III – The tumor grows quickly and is likely to spread into nearby tissue.  This tumor is considered malignant.
  • Grade IV – The tumor is malignant with features of fast growth and a high propensity to spread very quickly.

Staging is a system developed by the American Joint Committee on Cancer. It is also known as the TNM staging system. This system helps determine the extent of the tumor spread beyond its site of origin.

  • T=Tumor refers to the size and extent of the main tumor
  • N= Node refers to the number of nearby lymph nodes that have cancer
  • M= Metastasis refers to whether cancer has metastasized, or spread to other parts of the body

Metastatic spinal tumors are far more prevalent than primary spine tumors. Metastasis to the spinal column can occur in 3%-5% of all patients with cancers. It is important to understand that the cancer that has spread to the spine, is still considered the form of cancer where at first originated. The most common cancers that spread to the spine are breast, lung, prostate, and melanoma, where the incidence can be greater than 20%. Spinal metastases can cause pain, vertebral body collapse and spinal cord compression.

In the Neuro-Oncology Program at Moffitt Cancer Center, we treat patients with all grades and stages of spinal cancer. Our multispecialty team of experts collaboratively develops a highly individualized treatment plan for each patient. After taking into account a patient’s unique circumstances, we make evidence-based recommendations of the therapies we believe will be most effective for the patient’s specific grade or stage of spinal cancer.

Medically reviewed by Nam Tran, MD, PhD, Neuro-Oncology Surgeon.

No referral is required to consult with the oncologists specializing in spine cancer at Moffitt Cancer Center. To schedule an appointment, call 1-888-663-3488 or complete a new patient registration form online.