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Evidence. Clarity. Practice.

© 2026 OrthoVellum. For educational purposes only.

Not medical advice. Verify clinically important information against current local guidance.

Back to Research
Level IVMust KnowOncologyClassification System

Evidence brief

Enneking Staging System

A System of Staging Musculoskeletal Neoplasms

Authors
Enneking WF, Spanier SS, Goodman MA
Journal
Clin Orthop Relat Res
Year
1980

Key Findings

  • 1

    Based on Grade (G), Site (T), Metastasis (M)

  • 2

    Stage I: Low grade (A intracompartmental, B extracompartmental)

  • 3

    Stage II: High grade (A intra, B extracompartmental)

  • 4

    Stage III: Any grade with metastasis

  • 5

    Guides surgical margins and treatment

Clinical Implications

Enneking staging remains the foundation of musculoskeletal oncology, guiding treatment decisions and prognosis communication.

Teaching Note

Must know Enneking staging cold. Stage IIB most common for high-grade bone sarcomas. Understand compartmental anatomy. Know surgical margins: intralesional, marginal, wide, radical. Wide margin is standard for high-grade tumors. Discuss how staging guides treatment.

Citation

Enneking WF, Spanier SS, Goodman MA. A system of staging musculoskeletal neoplasms. Clin Orthop Relat Res. 1980;(153):106-120.

PubMed

Evidence Level

IV

Level IV

Case series or case reports

Topics

stagingEnnekingmusculoskeletal tumorsclassification

Related Topics

  • Musculoskeletal Tumors
  • Surgical Margins
  • Bone Sarcoma

External Links

View on PubMed

Related Papers

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Mirels H (1989)

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Simon MA (1986)

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Soft Tissue Sarcoma Management

Rosenberg SA (1982)