Staging
Staging is a process that tells a doctor if the cancer has spread, and if it has, how far. Staging of soft-tissue sarcoma depends on tumor size, tumor grade, and possible cancer spread to lymph nodes or distant sites. Tumor grade is a description of how the cancer cells look under a microscope compared to normal cells. Low-grade tumors look the most like normal cells under a microscope and are the slowest-growing. High-grade tumors look very abnormal under a microscope and are more aggressive. Staging is an important step in evaluating prognosis and treatment options, but so are other factors like location and subtype. Staging is also used to establish eligibility for some clinical trials. Please refer to the AJCC staging manual for more detail.
Stage Ia
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Description
- Tumor is low-grade and is no bigger than 5 cm in diameter.
Treatment
- Surgery to remove the tumor and a margin of healthy tissue. Radiation may be added sometimes or rarely be used alone if surgery is not possible. Only rarely would chemotherapy be considered.
Stage Ib
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Description
- Tumor is low-grade and is larger than 5 cm.
Treatment
- Surgery to remove the tumor and a margin of healthy tissue. Radiation may be added sometimes or rarely be used alone if surgery is not possible. Only rarely would chemotherapy be considered.
Stage II
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Description
- Tumor is intermediate-grade or high-grade and is no bigger than 5 cm.
Treatment
- Surgery to remove the tumor and a margin of healthy tissue. Patient may rarely be given chemotherapy and/or radiation therapy before surgery.
Stage IIIa
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Description
- Tumor is intermediate-grade or high-grade and is larger than 5 cm but less than or equal to 10 cm, with no or unknown lymph node involvement.
Treatment
- Surgery to remove the tumor and a margin of healthy tissue. Patient may be given chemotherapy and/or radiation therapy before surgery to shrink tumor as much as possible and decrease chance of recurrence, or after surgery to decrease the chance of recurrence.
Stage IIIb
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Description
- Tumor is intermediate-grade or high-grade and is larger than 10 cm OR any tumor size or grade but with lymph node spread of sarcoma.
Treatment
- Patient may be given chemotherapy and/or radiation therapy before surgery to shrink tumor as much as possible and decrease chance of recurrence. If feasible surgery to remove the tumor and a margin of healthy tissue. Nearby lymph nodes may also be removed. If surgery is done first, patient may be given chemotherapy and/or radiation therapy after surgery to decrease/delay recurrence.
Stage IV
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Description
- Any tumor size or grade that has metastasized (spread) to other parts of the body.
- OR
- Cancer has metastasized (spread) to other parts of the body, with unknown lymph node involvement.
Treatment
- Chemotherapy in general is he primary treatment for sarcoma that has metastasized. Surgery is still recommended under some circumstances, if the primary tumor and all secondary tumors can be completely removed with surgery, and if there is an unusually good response to chemotherapy. If there is no benefit in removing tumors, your doctor may recommend alternate systemic therapy or a clinical trial. Radiation therapy is used in some instances to relieve symptoms from a tumor.
