Staging
Staging is a method of determining whether cancer has spread to the soft tissues or to other regions of the body.
Soft tissue sarcoma is staged according to the tumor’s grade and size, as well as if it has progressed to the lymph nodes or other regions of the body.
Trunk and Extremities Sarcoma Stages (Source: AJCC)
AJCC stage | Stage grouping | Trunk and Extremities Sarcoma Stage description* |
IA | T1 N0 M0 G1 or GX | The cancer is 5 cm (2 inches) or smaller (T1). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 1 (G1) or the grade cannot be assessed (GX). |
IB | T2, T3, T4 N0 M0 G1 or GX |
The cancer is: · Larger than 5 cm but not more than 10 cm (T2) OR · Larger than 10cm but not more than 15 cm (T3) OR · Larger than 15 cm (T4). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 1 (G1) or the grade cannot be assessed (GX). |
II | T1 N0 M0 G2 or G3 | The cancer is 5 cm (2 inches) or smaller (T1). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 2 (G2) or grade 3 (G3). |
IIIA
| T2 N0 M0 G2 or G3 | The cancer is larger than 5 cm (2 inches) but not more than 10 cm (T2). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 2 (G2) or grade 3 (G3). |
IIIB | T3 or T4 N0 M0 G2 or G3 | The cancer is: · Larger than 10 cm but not more than 15 cm (T3) OR · Larger than 15 cm (T4). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 2 (G2) or grade 3 (G3). |
IV | Any T N1 M0 Any G | The cancer is any size (Any T) AND it has spread to nearby lymph nodes (N1). It has not spread to distant sites (M0). It can be any grade. |
OR | ||
Any T Any N M1 Any G | The cancer is any size (Any T) AND it has spread to nearby lymph nodes (N1). It has spread to distant sites such as the lungs (M1). It can be any grade. | |
Retroperitoneum Sarcoma Staging (Source: AJCC)
AJCC stage | Stage grouping | Retroperitoneum Sarcoma Stage description* |
IA | T1 N0 M0 G1 or GX | The cancer is 5 cm (2 inches) or smaller (T1). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 1 (G1) or the grade cannot be assessed (GX). |
IB | T2, T3, T4 N0 M0 G1 or GX | The cancer is: · Larger than 5 cm but not more than 10 cm OR · Larger than 10 cm but not more than 15 cm (T3) OR · Larger than 15 cm (T4). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 1 (G1) or the grade cannot be assessed (GX). |
II | T1 N0 M0 G2 or G3 | The cancer is 5 cm (2 inches) or smaller (T1). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 2 (G2) or grade 3 (G3). |
IIIA
| T2 N0 M0 G2 or G3 | The cancer is larger than 5 cm (2 inches) but not more than 10 cm (T2). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 2 (G2) or grade 3 (G3). |
IIIB | T3 or T4 N0 M0 G2 or G3 | The cancer is: · Larger than 10 cm but not more than 15 cm (T3) OR · Larger than 15 cm (T4). It has not spread to nearby lymph nodes (N0) or to distant sites (M0). The cancer is grade 2 (G2) or grade 3 (G3). |
OR | ||
Any T N1 M0 Any G | The cancer is any size (Any T) AND it has spread to nearby lymph nodes (N1). It has not spread to distant sites (M0). It can be any grade. | |
IV | Any T Any N M1 Any G | The cancer is any size (Any T) AND it has spread to nearby lymph nodes (N1). It has spread to distant sites such as the lungs (M1). It can be any grade. |
*The following categories are not listed in the table above:
- TX:Main tumor cannot be assessed due to lack of information.
- T0:No evidence of a primary tumor.
- NX:Regional lymph nodes cannot be assessed due to lack of information.
*The following categories are not listed in the tables above:
- TX:Main tumor cannot be assessed due to lack of information.
- T0:No evidence of a primary tumor.
- NX:Regional lymph nodes cannot be assessed due to lack of information.
In the staging process, the following tests and procedures may be used:
- Physical exam and medical history: A physical examination of the body to check for general indicators of health, as well as signs of disease, such as lumps or anything else strange.
A medical history of the patient’s health habits, as well as previous diseases and treatments, will be obtained.
- X-ray: An x-ray is a sort of radiation beam that may pass through the body and onto film, producing images of inside organs.
- Blood chemistry studies: A procedure in which a blood sample is checked to measure the amounts of certain substances released into the blood by organs and tissues in the body. An unusual (higher or lower than normal) amount of a substance can be a sign of disease.
- A complete blood count(CBC) is a technique that involves drawing a sample of blood and testing it for the following:
- Red blood cells, white blood cells, and platelets are all counted.
- The amount of hemoglobin (an oxygen-carrying protein) in red blood cells.
- Red blood cells make up a percentage of the blood sample.
- CT scan (CAT scan): A process that involves taking a series of detailed photographs from various angles of places inside the body, such as the lung and abdomen. A computer connected to an x-ray equipment creates the images.
To make the organs or tissues show up more clearly, a dye (contrast) may be injected into a vein or ingested orally.
- MRI (magnetic resonance imaging) is a method that involves the use of a magnet, radio waves, and a computer to create a sequence of detailed images of inside organs.
Nuclear magnetic resonance imaging is another name for this treatment (NMRI).
- PET scan (positron emission tomography scan): A process used to detect malignant tumor cells throughout the body.
A vein is injected with a little amount of radioactive glucose (sugar).
The PET scanner spins around the body, creating an image of where glucose is being used.
Because malignant tumor cells are more active and take up more glucose than normal cells, they appear brighter in the image.
The findings of these tests are analyzed combined with the results of the tumor biopsy to figure out the stage of the soft tissue sarcoma before therapy is administered.
Chemotherapy or radiation therapy may be used as the initial treatment, and the soft tissue sarcoma is then restaged.
