As well as the MSTS system for staging soft tissue sarcoma, there is an established American Joint Committee on Cancer Staging (AJCC) TNM system. This is in its seventh version.
Staging investigations typically involve local site imaging and CT of chest, possibly including the abdomen and pelvis. Nodal involvement is unusual, but may be more common in some types, such as clear cell sarcoma, epithelioid sarcoma and rhabdomyosarcoma.
The size cut off between T1 and T2 is 5cm, above which tumours are considered T2. Tumours above and not involving the deep fascia are considered superficial, those involving or deep to the fascia are considered deep.
Definitions for staging
|
TX |
Primary tumor cannot be assessed. |
|
T0 |
No evidence of primary tumor. |
|
T1 |
Tumor ≤5 cm in greatest dimension. (Size should be regarded as a continuous variable, and the measurement should be provided.) |
|
T1a |
Superficial tumor.b |
|
T1b |
Deep tumor.b |
|
T2 |
Tumor >5 cm in greatest dimension.b |
|
T2a |
Superficial tumor.b |
|
T2b |
Deep tumor. |
|
NX |
Regional lymph nodes cannot be assessed. |
|
N0 |
No regional lymph node metastasis. |
|
N1b |
Regional lymph node metastasis. |
|
M0 |
No distant metastasis. |
|
M1 |
Distant metastasis. |
|
Stage IA |
T1a |
N0 |
M0 |
G1, GX |
|
T1b |
N0 |
M0 |
G1, GX |
|
|
Stage IB |
T2a |
N0 |
M0 |
G1, GX |
|
T2b |
N0 |
M0 |
G1, GX |
|
|
Stage IIA |
T1a |
N0 |
M0 |
G2, G3 |
|
T1b |
N0 |
M0 |
G2, G3 |
|
|
Stage IIB |
T2a |
N0 |
M0 |
G2 |
|
T2b |
N0 |
M0 |
G2 |
|
|
Stage III |
T2a, T2b |
N0 |
M0 |
G3 |
|
Any T |
N1 |
M0 |
Any G |
|
|
Stage IV |
Any T |
Any N |
M1 |
Any G |
Reference:
AJCC: Soft tissue sarcoma. In: Edge SB, Byrd DR, Compton CC, et al., eds.: AJCC Cancer Staging Manual. 7th ed. New York, NY: Springer, 2010, pp 291-8.
