Knowing the stage and grade of your sarcoma helps your doctors plan the best treatment for you.
This is because your stage and grade will help them understand how your cancer might behave.
It also helps them communicate with other healthcare professionals about your case.
Grading sarcoma
Grading describes how cancer cells look compared to normal cells. It indicates how quickly the cancer might grow.
How doctors determine the grade
Doctors examine a biopsy (sample) of the cancer cells under a microscope. They look at:
- how much the sarcoma cells look like normal cells (differentiation)
- how quickly the sarcoma cells are dividing (mitotic rate)
- how much dead tissue is present (necrosis)
Doctors use the following grades for sarcoma:
| Grade | Appearance | Growth rate | Spread likelihood |
|---|---|---|---|
| Grade 1 | Look similar to normal cells | Slow-growing | Less likely to spread |
| Grade 2 | Look less similar to normal cells | Growing slightly faster | More likely to spread than grade 1 |
| Grade 3 | Look very different to normal cells | Fast-growing | More likely to spread than grade 2 |
Sarcoma staging
Staging describes how much the tumour has grown. Doctors use information about your grade to determine the stage of your sarcoma.
This will help them recommend the best treatment for you.
Doctors use different staging systems for different types of sarcoma. For some types of sarcoma, they don’t use staging systems at all.
In general, there are 2 staging systems doctors normally use in the UK:
- TNM staging
- Number staging
TNM staging
TNM staging is a system doctors use to describe the size of the tumour and whether or not it has spread. The letters stand for:
- T (Tumour): Size of the main tumour
- N (Node): Spread to lymph nodes
- M (Metastasis): Spread to other parts of the body
Tumour (T) stage
The T stage describes the tumour’s size. There are 4 main stages:
- T1: Smallest tumour size
- T2: Larger than T1
- T3: Larger than T2
- T4: Largest tumour size
Note: Different types of sarcomas and body locations might have specific T stage criteria.
Node (N) stage
The N stage shows if your cancer has spread to the lymph nodes. There are 3 N stages:
- NX: Lymph nodes could not be assessed
- N0: No cancer in lymph nodes
- N1: Cancer found in lymph nodes
Metastasis (M) stage
The M stage shows if your cancer has spread to another part of the body. This is called metastasis or secondary cancer. There are 2 M stages:
- M0: No spread to another part of the body
- M1: Cancer has spread to another part of the body
Your doctor will combine these three factors into a complete stage, such as ‘T2N0M0’.
For example, a less advanced example of T1N1M0 means small tumour (T1), some lymph node spread (N1), and no spread to other body parts (M0).
A more advanced example of T4N1M1 means large tumour (T4), spread to lymph nodes (N1), and spread to other body parts (M1).
Every person’s cancer is unique. Ask your doctor to explain what your TNM stage means for your situation and treatment plan.
Number staging
Number staging is a system used to describe how advanced a sarcoma is. Different types of sarcoma use different staging systems, and some rare types may not have specific stages.
This staging system applies to sarcomas in the:
- trunk (torso)
- retroperitoneum (area behind your tummy)
- arms
- legs
| Stage | Size | Spread | Grade |
|---|---|---|---|
| Stage 1a | Smaller than 5cm | No spread | Grade 1 or unassessed |
| Stage 1b | Larger than 5cm | No spread | Grade 1 or unassessed |
| Stage 2 | Smaller than 5cm | No spread | Grade 2 or 3 |
| Stage 3a | 5-10cm | No spread | Grade 2 or 3 |
| Stage 3b | Larger than 10cm | No spread | Grade 2 or 3 |
| Stage 4 | Any size | Spread to lymph nodes or other body parts | Any grade |
Why your stage matters
Understanding your sarcoma’s stage is important because it might affect:
- your treatment options
- your treatment plan
- the risk of your cancer spreading
- your follow-up care
Can your stage or grade change?
Grade
Some people’s cancer grade might change over time. For example, your cancer might start growing at a different rate after surgery or other treatment. It might also stop growing.
It’s important that you know if the grade of your sarcoma changes. Your doctor or nurse should be able to tell you about your grade.
Stage
The stage of your cancer does not change from when you were diagnosed. If anything did change with your cancer, new information would be added onto your stage, without changing it.
This is so doctors can understand how your cancer might have changed, so they can offer you the best treatment.
Remember, your healthcare team are there to support you. Don’t hesitate to ask them any questions, and always ask for clarification if you don’t understand something.
Last reviewed: November 2024 | Next review due: November 2027
