The staging and surgery of musculoskeletal neoplasms.

This review has outlined the surgical staging of benign and malignant musculoskeletal neoplasms. Based on their unique natural history, these neoplasms behave in a predictable fashion. The surgical staging system assigns progressively higher degrees of risks to the neoplasms based on their surgical grade, their anatomic location, and the presence or absence of metastases. The staging system articulates well with preoperative planning, defining the margins needed for local tumor control. Because surgery distorts most of the imaging modalities available, all clinical staging studies must be completed before surgical intervention. As more data accrue as to the importance of DNA ploidy, genetic markers, and other characteristics, it is likely they will play an important role in the diagnosis and treatment of musculoskeletal neoplasms in the future.