Soft Tissues

TNM 7 classification

TNM 6 classification

1. Rules for Classification

There should be histological confirmation of the disease and division of
cases by histological type and grade.



The following are the procedures for assessing T, N, and M categories:



T categories. Physical examination and imaging

N categories. Physical examination and imaging

M categories. Physical examination and imaging

2. Anatomical Sites

1. Connective, subcutaneous, and other soft tissues (C49), peripheral nerves (C47)

2. Retroperitoneum (C48.0)

3. Mediastinum: anterior (38.1); posterior (C38.2); mediastinum, NOS (C38.3)

3. Histological Types of Tumour

The following histological types are included, with ICD-O morphology codes:

Alveolar soft part sarcoma 9581/3 Epithelioid sarcoma 8804/3 Extraskeletal chondrosarcoma 9220/3 Extraskeletal osteosarcoma 9180/3 Extraskeletal Ewing sarcoma 9260/3 Primitive neuroectodermal tumour (PNET) 9473/3 Fibrosarcoma 8810/3 Leiomyosarcoma 8890/3 Liposarcoma 8850/3 Malignant fibrous histiocytoma 8830/3 Malignant hemangiopericytoma 9150/3 Malignant mesenchymoma 8990/3 Malignant peripheral nerve sheath tumour 9540/3 Rhabdomyosarcoma 8900/3 Synovial sarcoma 9040/3 Sarcoma NOS (not otherwise specified) 8800/3

The following histological types are not included: Kaposi sarcoma, dermatofibrosarcoma (protuberans), fibromatosis (desmoid
tumour), and sarcoma arising from the dura mater, brain, hollow viscera, or parenchymatous organs (with the exception of breast
sarcomas). Angiosarcoma, an aggressive sarcoma, is excluded because its natural history is not consistent with the classification.

4. Regional Lymph Nodes

The regional lymph nodes are those appropriate to the site of the primary tumour. Regional node involvement is rare and cases in which nodal status is not assessed either clinically or pathologically could be considered N0 instead of NX or pNX.

5. TNM Clinical Classification

5.1. T - Primary Tumour



TX. Primary tumour cannot be assessed

T0. No evidence of primary tumour

T1. Tumour 5 cm or less in greatest dimension

T1a. Superficial tumour*

T1b. Deep tumour*

T2. Tumour more than 5 cm in greatest dimension

T2a. Superficial tumour*

T2b. Deep tumour*



5.2. N - Regional Lymph Nodes



NX. Regional lymph nodes cannot be assessed

N0. No regional lymph node metastasis

N1. Regional lymph node metastasis



5.3. M - Distant Metastasis



MX. Distant metastasis cannot be assessed

M0. No distant metastasis

M1. Distant metastasis

6. pTNM Pathological Classification

The pT, pN, and pM categories correspond to the T, N, and M categories.

7. G Histopathological Grading

Translation table for three- and four-grade systems to a two-grade (low grade vs. high grade) system

TNM two-grade system Three-grade systems Four-grade systems Low grade Grade 1 Grade 1 Grade 2 High grade Grade 2 Grade 3 Grade 3 Grade 4

Note: Extraskeletal Ewing and primitive neuroectodermal tumours are classified as high grade.

8. Stage Grouping

Stage IA T1a N0,NX M0 Low grade T1b N0,NX M0 Low grade Stage IB T2a N0,NX M0 Low grade T2b N0,NX M0 Low grade Stage IIA T1a N0,NX M0 High grade T1b N0,NX M0 High grade Stage IIB T2a N0,NX M0 High grade Stage III T2b N0,NX M0 High grade Stage IV Any T N1 M0 Any grade Any T Any N M1 Any grade

9. Summary

Soft Tissue Sarcoma T1 ≤5 cm T1a Superficial T1b Deep T2 >5 cm T2a Superficial T2b Deep N1 Regional Low grade High grade