Soft tissue
Staging
Sarcomas of the head and neck

Author: Faizan Malik, M.B.B.S. (see Authors page)
Senior Author: Michael R. Clay, M.D.
Editor-in-Chief Review: Debra Zynger, M.D.

Revised: 6 December 2018, last major update November 2018

Copyright: (c) 2018, PathologyOutlines.com, Inc.

PubMed Search: Staging[TIAB] soft tissue sarcomas of head and neck[TIAB]

Cite this page: Malik F, Clay MR. Staging - sarcomas of the head and neck. PathologyOutlines.com website. http://www.pathologyoutlines.com/topic/softtissuestagingheadneck.html. Accessed December 16th, 2018.

Pathologic TNM staging of sarcomas of the head and neck, AJCC 8th edition
Introduction
Primary tumor (pT)
  • pTX: Primary tumor cannot be assessed
  • pT1: Tumor ≤ 2 cm in greatest dimension
  • pT2: Tumor > 2 cm and ≤ 4 cm
  • pT3: Tumor > 4 cm
  • pT4: Tumor with invasion of adjoining structures
    • pT4a: Orbital, skull base / dural, central compartment viscera, fascial skeleton or pterygoid muscle invasion
    • pT4b: Brain parenchymal invasion, carotid artery encasement, prevertebral muscle invasion or central nervous system involvement via perineural spread

Notes:
  • Note the lower cutoffs for tumor size (aggressive tumors are identified at smaller size in this region of the body)
  • Largest tumor diameter (in any plane) should be measured
  • Special consideration should be given to tumors that may have tail-like projections, such as undifferentiated pleomorphic sarcoma and myxofibrosarcoma
  • Surrounding edema, if present, should be excluded from size measurement
Regional lymph nodes (pN)
  • pN0: No regional lymph node metastasis
  • pN1: Regional lymph node metastasis

Notes:
  • pNX is not used for soft tissue tumors and no pN should be reported if no lymph nodes are present
Distant metastasis (pM)
  • pM1: Distant metastasis
Histologic grade (G)
  • GX: Grade cannot be assessed
  • G1: Total differentiation, mitotic count and necrosis score of 2 or 3
  • G2: Total differentiation, mitotic count and necrosis score of 4 or 5
  • G3: Total differentiation, mitotic count and necrosis score of 6, 7 or 8

Notes:
AJCC prognostic stage groups
  • Since this is a new classification and still needs data collection, prognostic stage grouping is not yet defined

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