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