Staging-abdomen and thorax

Soft tissue

General

Authors: Faizan Malik, M.B.B.S., Michael R. Clay, M.D.

Editor-in-Chief: Debra Zynger, M.D.

Topic Completed: 1 November 2018

Minor changes: 14 July 2020

Copyright: 2018-2019, PathologyOutlines.com, Inc.

PubMed Search: Staging[TIAB] soft tissue sarcomas of abdomen

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Table of Contents

Cite this page: Malik F, Clay MR. Staging-abdomen and thorax. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/softtissuestagingabdomen.html. Accessed August 8th, 2020.

Pathologic TNM staging of sarcomas of the abdomen and thoracic visceral organs, AJCC 8th edition

Introduction

Sarcomas not staged according to this staging system include desmoplastic small round cell tumor (DSRCT), epithelioid hemangioendothelioma (EHE), inflammatory myofibroblastic tumor (IMT), perivascular epithelioid cell tumor (PEComa), solitary fibrous tumor (SFT), gastrointestinal stromal tumor (GIST), uterine leiomyosarcoma and retroperitoneal leiomyosarcoma; these tumors should be staged as follows:
- DSRCT and EHE: follow guidelines for sarcomas with unusual histologies and sites
- SFT: follow guidelines for sarcomas of the retroperitoneum
- GIST: follow guidelines for gastrointestinal stromal tumor
- Uterine leiomyosarcoma: follow guidelines for uterine corpus sarcoma
- Retroperitoneal leiomyosarcoma: follow guidelines for sarcomas of the retroperitoneum
- IMT and PEComa are not currently staged according to the AJCC system
Embryonal sarcoma, typically found in the liver, is staged according to this system

Primary tumor (pT)

pTX: Primary tumor cannot be assessed
pT1: Organ confined tumor
pT2: Tumor extension into tissue beyond organ
- pT2a: Invades serosa or visceral peritoneum
- pT2b: Extension beyond serosa
pT3: Invades another organ
pT4: Multifocal involvement
- pT4a: Multifocal (2 sites)
- pT4b: Multifocal (3 - 5 sites)
- pT4c: Multifocal (> 5 sites)

Regional lymph nodes (pN)

pN0: No lymph node involvement
pN1: Lymph node involvement present

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: Metastases present

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:

See AJCC staging manual for guidance regarding differentiation scores (Amin: AJCC Cancer Staging Manual, 8th Edition, 2018)

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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