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Soft tissue sarcoma

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Staging soft tissue sarcoma

Staging is a way of describing or classifying a cancer based on the extent, or amount, of cancer in the body. The most common staging system for soft tissue sarcoma is the TNM system.

  • T describes the size of the primary tumour and if it has grown into tissues around the soft tissue tumour.
  • N describes the number and location of any lymph nodes around the soft tissue tumour that have cancer cells in them.
  • M describes whether or not the cancer has spread, or metastasized, to other parts of the body.

Stage grouping for soft tissue sarcoma

Overall stages, or stage groupings, are based on the TNM system. Each stage is given a number from 1 to 4, usually as a Roman numeral (I, II, III or IV). Generally, the higher the number, the further the cancer has progressed. Your healthcare team uses the stage grouping to plan treatment and estimate prognosis.

When describing the stage, doctors may use the terms regional and distant. Regional means close to or around the soft tissue tumour. Distant means in a part of the body farther from the soft tissue tumour.

Stage grouping for soft tissue sarcoma also includes the grade of the tumour. The grade is based on how the cancer cells look and behave compared to normal cells under a microscope.

The following staging information does not apply to the following types of soft tissue sarcoma:

  • Kaposi sarcoma (KS)
  • dermatofibrosarcoma protuberans
  • fibromatosis (desmoid tumour)
  • sarcomas that begin in the brain, lining around the brain and spinal cord (dura mater), hollow organs (viscera) or parenchymatous organs (with the exception of breast sarcoma)
  • angiosarcoma (sarcoma of blood vessels)
  • gastrointestinal stromal tumours (GISTs)

Stage IA

Stage IA soft tissue sarcoma can be either of the following.

StageTNM and GradeExplanation

stage IA

T1a

The tumour is superficial (near the surface of the body) and 5 cm or less in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G1 or GX

The tumour is grade 1 (low grade) or cannot be assessed.

stage IA

T1b

The tumour is deep in the limb or abdomen and 5 cm or less in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G1 or GX

The tumour is grade 1 (low grade) or cannot be assessed.

Stage IB

Stage IB soft tissue sarcoma can be either of the following.

StageTNM and GradeExplanation

stage IB

T2a

The tumour is superficial (near the surface of the body) and more than 5 cm in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G1 or GX

The tumour is grade 1 (low grade) or cannot be assessed.

stage IB

T2b

The tumour is deep in the limb or abdomen and more than 5 cm in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G1 or GX

The tumour is grade 1 (low grade) or cannot be assessed.

Stage IIA

Stage IIA soft tissue sarcoma can be either of the following.

StageTNM and GradeExplanation

stage IIA

T1a

The tumour is superficial (near the surface of the body) and 5 cm or less in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G2 or G3

The tumour is grade 2 or 3 (high grade).

stage IIA

T1b

The tumour is deep in the limb or abdomen and 5 cm or less in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G2 or G3

The tumour is grade 2 or 3 (high grade).

Stage IIB

The following describes all stage IIB soft tissue sarcomas.

Stage

TNM and Grade

Explanation

stage IIB

T2a

The tumour is superficial (near the surface of the body) and more than 5 cm in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G2 or G3

The tumour is grade 2 or 3 (high grade).

Stage III

Stage III soft tissue sarcoma can be either of the following.

Stage

TNM and Grade

Explanation

stage III

T2b

The tumour is deep in the limb or abdomen and more than 5 cm in size.

N0

No regional lymph node metastasis (no cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

G2 or G3

The tumour is grade 2 or 3 (high grade).

stage III

any T

The tumour can be any size.

N1

Regional lymph node metastasis (cancer cells in lymph nodes near the soft tissue tumour).

M0

No distant metastasis (cancer hasn’t spread to other parts of the body).

any G

The tumour can be any grade (low or high grade).

Stage IV

The following describes all stage IV soft tissue sarcomas.

StageTNM and GradeExplanation

stage IV

any T

The tumour can be any size.

any N

There may or may not be regional lymph node metastasis (cancer cells may or may not be in lymph nodes near the soft tissue tumour).

M1

There is distant metastasis (cancer has spread to other parts of the body, such as the lungs or liver).

any G

The tumour can be any grade.

Recurrent soft tissue sarcoma

Recurrent soft tissue sarcoma means that the cancer has come back after it has been treated. If it comes back in the same place that the cancer first started, it’s called local recurrence. If it comes back in tissues or lymph nodes close to the primary tumour, it’s called regional recurrence. It can also recur in another part of the body, which is called metastatic soft tissue sarcoma.

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