Soft tissue
Staging
Sarcomas of the trunk and extremities

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: 5 December 2018, last major update November 2018

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

PubMed Search: Staging soft tissue sarcomas of trunk and extremities

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

Pathologic TNM staging of sarcomas of the trunk and extremities, AJCC 8th edition
Introduction
Primary tumor (pT)
  • pTX: Primary tumor cannot be assessed
  • pT0: No evidence of primary tumor
  • pT1: Tumor ≤ 5 cm in greatest dimension
  • pT2: Tumor > 5 cm and ≤ 10 cm in greatest dimension
  • pT3: Tumor > 10 cm and ≤ 15 cm in greatest dimension
  • pT4: Tumor > 15 cm in greatest dimension

Notes:
  • 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 involvement
  • 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
AJCC prognostic stage groups

  AJCC stage     Stage grouping   Trunk and extremities sarcoma stage
IA T1 Cancer is ≤ 5 cm (2 in) (T1)
N0 It has not spread to nearby lymph nodes (N0)
M0 It has not spread to distant sites (M0)
G1 or GX Cancer is grade 1 (G1) or the grade cannot be assessed (GX)
IB T2, T3, T4 Cancer is > 5 cm but ≤ 10 cm (T2) OR > 10 cm but ≤ 15 cm (T3) OR > 15 cm (T4)
N0 It has not spread to nearby lymph nodes (N0)
M0 It has not spread to distant sites (M0)
G1 or GX Cancer is grade 1 (G1) or the grade cannot be assessed (GX)
II T1 Cancer is ≤ 5 cm (2 in) (T1)
N0 It has not spread to nearby lymph nodes (N0)
M0 It has not spread to distant sites (M0)
G2 or G3 Cancer is grade 2 (G2) or grade 3 (G3)
IIIA T2 Cancer is > 5 cm but ≤ 10 cm (T2)
N0 It has not spread to nearby lymph nodes (N0)
M0 It has not spread to distant sites (M0)
G2 or G3 Cancer is grade 2 (G2) or grade 3 (G3)
IIIB T3 or T4 Cancer is > 10 cm but ≤ 15 cm (T3) OR > 15 cm (T4)
N0 It has not spread to nearby lymph nodes (N0)
M0 It has not spread to distant sites (M0)
G2 or G3 Cancer is grade 2 (G2) or grade 3 (G3)
IV Any T Cancer is any size (any T) AND
N1 It has spread to nearby lymph nodes (N1)
M0 It has not spread to distant sites (M0)
Any G It can be any grade
OR
Any T Cancer is any size (any T) AND
Any N It has or has not spread to nearby lymph nodes (any N)
M1 It has spread to distant sites such as the lungs (M1)
Any G It can be any grade

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