Soft Tissue Sarcoma Staging 

Updated: Nov 16, 2015
  • Author: from Memorial Sloan-Kettering - Mrinal M Gounder, MD; Chief Editor: Jules E Harris, MD, FACP, FRCPC  more...
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TNM Classification for Soft Tissue Sarcoma

The TNM classification for soft tissue sarcoma is provided below. [1]

Histology and grade are critical components of staging. Lymph node involvement is not characteristic of most sarcomas except rhabdomyosarcoma and synovial, clear cell, vascular, and epithelioid sarcomas.

These guidelines do not pertain to the management of gastrointestinal stroma tumors (GISTs), rhabdomyosarcoma, Ewing sarcoma, desmoplastic round cell tumors, and primitive neuroectodermal tumors.

See Soft-Tissue Sarcomas: What You Need to Know, a Critical Images slideshow, to help identify and treat some of these malignant tumors of mesenchymal origin.

Table. TNM Classification for Soft Tissue Sarcoma (Open Table in a new window)

Primary tumor (T)
TX Primary tumor cannot be assessed
T0 No evidence of primary tumor
T1 Tumor ≤ 5 cm in greatest dimension*
T1a Superficial tumor
T1b Deep tumor
T2 Tumor > 5 cm in greatest dimension*
T2a Superficial tumor
T2b Deep tumor
*The superficial tumor is located exclusively above the superficial fascia without invasion of the fascia; the deep tumor is located in any of the following: exclusively beneath the superficial fascia, superficial to the fascia, with invasion of or through the fascia, or both superficial to and beneath the fascia.
Regional lymph nodes (N)
NX Regional lymph nodes cannot be assessed
N0 No regional lymph node metastasis
N1 Regional lymph node metastasis
The presence of positive nodes (N1) in M0 tumors is considered stage III.
Distant metastasis (M)
M0 No distant metastasis
M1 Distant metastasis

Table. Histologic grade (Open Table in a new window)

Histologic grade (G)
GX Grade cannot be assessed
G1 Grade 1
G2 Grade 2
G3 Grade 3

Table. Anatomic stage/prognostic groups (Open Table in a new window)

Stage T N M Histologic grade
Stage IA T1a N0 M0 G1, GX
T1b N0 M0 G1, GX
Stage IB T2a N0 M0 G1, GX
T2b N0 M0 G1, GX
Stage IIA T1a N0 M0 G2, G3
T1b N0 M0 G2, G3
Stage IIB T2a N0 M0 G2
T2b N0 M0 G2
Stage III T2a, T2b N0 M0 G3
Any T N1 M0 Any G
Stage IV Any T Any N M1 Any G