A system for the surgical staging of musculoskeletal sarcoma.
Enneking WF, Spanier SS, Goodman MA. Clinical orthopaedics and related research 1980 · PMID 7449206
- Question
- How can musculoskeletal sarcomas be staged to guide surgical margins and predict outcome?
- Design
- Description of a surgical staging system for bone and soft tissue sarcoma, linked to defined surgical margins.
- Patients
- Patients with bone and soft tissue sarcomas treated surgically.
- Intervention
- Staging by grade (low/high), anatomical site (intra-/extra-compartmental) and metastases
- Comparison
- Outcomes across stages
- Primary outcome
- Prognostic risk by stage (no single trial outcome)
- Key result
- Stage I (low grade), II (high grade) and III (metastatic), each subdivided into A (intracompartmental) and B (extracompartmental), stratified prognosis and linked to defined surgical margins (intralesional, marginal, wide, radical).
- Limitations
- Predates modern imaging and chemotherapy; largely superseded by AJCC staging for oncological reporting.
- Impact on practice
- The Enneking stages and margin definitions remain the core vocabulary for surgical planning and are routinely examined, alongside the related benign lesion staging.