Staging involves evaluating how far a cancer has spread.  Staging information is an important factor in determining a treatment path and a patient’s prognosis (the chances of living a “normal” lifespan), but is not the only information considered.  Other information important for selecting the best treatment for an individual patient includes imaging tests of the main tumor to see its size and location and imaging tests of other parts of the body to determine if the cancer has spread.  All this information will assist you and your physician in arriving at a decision about the best course of treatment for you.

In sarcoma staging, pathologists and other cancer specialists examine the appearance of the tumor biopsy specimen. They determine the cell type of the tumor, how actively the cells are dividing, and how closely the cancer cells resemble normal tissue. Based on cell type and grade, doctors can estimate how rapidly a cancer will grow and spread.

The staging system is a standard method used by cancer health care teams to summarize the extent of a cancer’s spread. The system was developed by the American Joint Committee on Cancer (AJCC) and is called the TNM System. In this system, T stands for the size of the Tumor (tumors are measured using the metric system, 5 cm equals about 2 in), N stands for spread to the lymph Nodes, and M stands for Metastasis (spread to distant organs).

In soft tissue and bone sarcomas, another key factor that must be considered is histopathologic Grade (G), or the microscopic appearance of the tumor compared to the normal tissue from which it originated.  There are Grades I through IV, the first being the least aggressive and likely to metastasize to other parts of the body, and Grade IV being the most aggressive with a higher probability of spreading.

To assign a stage, information about the tumor, lymph nodes, metastasis, and the tumor grade is combined by a process called stage grouping. The stage is described by Roman numerals from I to IV.

For a more detailed Staging System, please refer to the NCCN Clinical Practice Guidelines in Oncology, Soft Tissue Sarcoma V.1.2009 and Bone Cancer V.1.2009. This can also be found on the NCCN website (www.nccn.org).