The grade of a cancer gives the doctors an idea of how quickly it might grow. Doctors look at a sample of the cancer cells under a microscope to find the grade.
The grade is based on 3 things:
- how normal or abnormal the cells look – this is called differentiation
- how quickly the cells are dividing to make new tumour cells – this is called the mitotic rate
- if there is any dying tissue in the tumour – this is called necrosis.
Doctors use the following 3 grades:
- G1 cancer cells look much like normal cells. They are usually slow-growing and less likely to spread.
- G2 cancer cells look different to normal cells. They are slightly faster-growing.
- G3 cancer cells look very different to normal cells. They can grow more quickly and are more likely to spread.
The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage helps doctors decide on the best treatment for you.
Different staging systems may be used. 2 of the most commonly used systems are the TNM and number staging system. Different types of sarcoma use different staging systems.
TNM stands for Tumour, Node and Metastasis.
- T describes the size of the tumour.
- N describes whether the cancer has spread to the lymph nodes.
- M describes whether the cancer has spread to another part of the body, such as the lungs or liver. This is called metastatic or secondary cancer.
Doctors put numbers after the T, N, and M giving more details about the size and spread of the cancer.
Information from the TNM system and the grade of the cancer can be combined to give a number stage. This list shows number staging of soft tissue sarcomas (STS) that start in the arms, legs or main part of the body (the trunk).
It is divided into 4 stages.
Stage 1 means the sarcoma has not spread to nearby lymph nodes, or other parts of the body. Stage 1 is divided into the following stages:
- Stage 1A is 5cm or less, and is grade 1.
- is bigger than 5cm and may be over 15 cm. It is either grade 1, or the grade cannot be assessed.
Stage 2 means the sarcoma has not spread the nearby lymph nodes or other parts of the body. Stage 2 is 5cm or less. It is grade 2 or grade 3.
Stage 3 means the sarcoma has not spread to nearby lymph nodes or other parts of the body. Stage 3 is divided into the following stages:
- Stage 3A is bigger than 5cm, but not more than 10cm. It is grade 2 or grade 3.
- Stage 3B is bigger than 10cm. It may be over 15cm. It is grade 2 or grade 3.
Stage 4 means the sarcoma is advanced. It can be any size and any grade. It has spread to either:
- the lymph nodes nearby
- other parts of the body such as the lungs, liver or bones – this is called secondary or metastatic cancer.
Your doctor or specialist nurse can give you more information about the grade and stage of the sarcoma.
Below is a sample of the sources used in our soft tissue sarcoma information. If you would like more information about the sources we use, please contact us at email@example.com
Gronchi A, Miah AB et al. Soft tissue and visceral sarcomas: ESMO-EURACAN-GENTURIS Clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2021; 32, 11, 1348-1365 [accessed May 2022].
Casali PG, Blay JY et al. Gastrointestinal stromal tumours: ESMO-EURACAN-GENTURIS Clinical practice guidelines for diagnosis, treatment and follow-up. Annals of Oncology, 2022; 33,1, 20-33 [accessed May 2022].
This information has been written, revised and edited by Macmillan Cancer Support’s Cancer Information Development team. It has been reviewed by expert medical and health professionals and people living with cancer. It has been approved by senior medical editor Fiona Cowie, Consultant Clinical Oncologist.
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