This reference uses AJCC 8, confirmed current for this site on 4 November 2026. UICC TNM 9th edition, effective in 2026, is a separate system. Record the organisation, edition, anatomical location and c/p/yc/yp staging prefix. AJCC · UICC.
AJCC prognostic stage groups apply to adult soft-tissue sarcoma of extremity/superficial trunk and retroperitoneum with different nodal grouping. No formal prognostic stage groups for soft-tissue sarcoma of head and neck or abdominal/thoracic visceral organs in AJCC 8.
T size, nodal and distant spread, FNCLCC grade
| T category | Greatest dimension | Important caveat |
|---|---|---|
| T1 | ≤5 cm | Do not infer grade from size. |
| T2 | >5 to ≤10 cm | Anatomical depth is clinically relevant but does not itself define extremity T. |
| T3 | >10 to ≤15 cm | Vascular/nerve relationship matters independently. |
| T4 | >15 cm | Often requires complex surgical planning. |
| N0/N1; M0/M1 | Regional nodes absent/present; distant disease absent/present | N1 groups differ between sites. |
| G1/G2/G3/GX | FNCLCC differentiation, mitoses and necrosis | Not every sarcoma subtype is graded using FNCLCC. |
Stage groups - extremity and superficial trunk
| AJCC 8 group | TNM/grade | Interpretation |
|---|---|---|
| IA | T1 N0 M0 G1/GX | Small low/unassessable-grade local lesion. |
| IB | T2-T4 N0 M0 G1/GX | Larger lower-grade localised lesion. |
| II | T1 N0 M0 G2/G3 | ≤5 cm, higher-grade local lesion. |
| IIIA | T2 N0 M0 G2/G3 | >5-10 cm, higher-grade lesion. |
| IIIB | T3-T4 N0 M0 G2/G3 | >10 cm, higher-grade lesion. |
| IV | Any T with N1 M0 or any M1 | AJCC 8: N1 places extremity/trunk soft-tissue sarcoma in stage IV. |
FNCLCC grading: the three-component score
The histological FNCLCC grade combines differentiation, mitotic activity and tumour necrosis. Scores are added only for applicable histotypes; mitotic counting requires an appropriate standardised microscopic field area.
| Criterion | Assessment | Score |
|---|---|---|
| Differentiation | Resembles mature mesenchymal tissue / recognisable sarcoma type / embryonal or undifferentiated | 1 / 2 / 3 |
| Mitotic activity | 0-9 / 10-19 / ≥20 mitoses per 10 high-power fields (using a standardised counting area) | 1 / 2 / 3 |
| Tumour necrosis | Absent / less than 50% / 50% or greater | 0 / 1 / 2 |
| Total | 2-3 / 4-5 / 6-8 points | G1 / G2 / G3 |
Do not assign FNCLCC grade based solely on size, ulceration or MRI. For specific histotypes, the specialist pathologist should indicate if FNCLCC is applicable; otherwise histology-adapted risk assessment is needed.
Reference: NCI Soft Tissue Sarcoma PDQ - FNCLCC criteria and grade groups.
Retroperitoneal sarcoma exception
The same T size thresholds and grade system apply where relevant, but N1 M0 falls in group IIIB for retroperitoneal sarcoma, rather than IV. Any M1 is stage IV. Report the anatomical site explicitly.
GIST, DFSP, selected vascular and other distinct sarcoma entities require subtype-specific classification or risk interpretation. FNCLCC cannot be assigned mechanically to every entity.
Minimum MDT record
Compartment, WHO diagnosis, primary versus recurrent disease.
Applicable FNCLCC grade, IHC/molecular data, resection margins.
MRI size, chest staging, N/M and treatment-specific c/p/yc/yp prefixes.
Sources: NCI Adult STS PDQ; NHS STS TNM8; AJCC current staging.
Other staging systems
Educational reference, not a substitute for specialist MDT review or official AJCC protocols. Record the edition used and do not infer a stage group from a single image.