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Understanding Your Grade and Stage of Soft Tissue Sarcoma

A pathologist is a specialized doctor who looks at tissue samples under a microscope to determine whether they are cancerous or not. The tissue samples are removed during a biopsy. If your doctor suspects a sarcoma, it is important to be sure that a pathologist who is an expert in sarcoma pathology reviews your tissue as well. Since there are not that many expert pathologists in the United States who specialize in sarcoma pathology, you may need to request a specialized pathology review.

Pathologists determine the specific type of sarcoma you have. They also determine the grade of your tumor. The grade tells your doctor how your cancer may behave or how likely it is to spread to other parts of the body. Sarcomas are graded on a scale from G1 to G3. A low-grade (G1) tumor closely resembles normal cells. A high-grade (G3) tumor may spread more readily to other parts of the body. Medium-grade (G2) tumors are somewhere in between. 

In addition to your tumor’s grade, doctors need to determine the stage of your sarcoma. The staging system takes into account the size and location of your original tumor and whether the tumor has spread to nearby lymph nodes or other parts of your body. For sarcomas, the grade is also an important part of the staging system.  

These are the American Joint Committee on Cancer stages for soft tissue sarcoma:

  • Stage IA. The cancer is low-grade and not larger than 5 centimeters (cm), or about 2 inches, across. It has not spread to the lymph nodes or other parts of the body.

  • Stage IB.  The cancer is low-grade and is larger than 5 cm across. It has not spread to the lymph nodes or other parts of the body. 

  • Stage IIA. The cancer is medium- or high-grade and not larger than 5 cm across. It has not spread to the lymph nodes or other parts of the body.

  • Stage IIB. The cancer is medium-grade and larger than 5 cm across. It has not spread to the lymph nodes or other parts of the body.

  • Stage III. The cancer is high-grade and larger than 5 cm across. It has not spread to the lymph nodes or other parts of the body. Or the cancer is any size or grade, but it has spread to the lymph nodes (and not to distant parts of the body).

  • Stage IV. The cancer is any size or grade and may or may not have spread to the lymph nodes, but it has spread to distant parts of the body.