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II-T1a
14%
8/57
II-T1b
30%
17/57
II-T2a
35%
20/57
III
21%
12/57
IV
0%
0/57
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The AJCC staging system for soft-tissue sarcomas is based on tumor grade, size, depth, and the presence of metastases. Stage I tumors are low grade. Stage II tumors are high grade. Grade is considered high grade for G3 or G4 tumors on a four-tier grading system and for G2 or G3 on a three-tier grading system. Size is designated by T1 for a size of less than or equal to 5.0 cm or T2 for a size of greater than 5.0 cm in maximal dimension. An 'a' or 'b' designation immediately follows the size designation to distinguish between superficial (a) and deep (b) tumors. The "deep" designation applies to tumors that involve or are deep to the fascia. Stage III tumors are high grade, deep, and large (eg, T2b). Stage IV tumors include either N1 (nodal) or M1 (distant) metastases regardless of grade. Hence, stage II-T1a would refer to a high grade small superficial sarcoma. Stage II-T1b is a high grade small deep sarcoma. Stage II-T2a is a high grade large superficial tumor. The tumor presented in this case is high grade (G3 or G4), large (>5.0 cm), intramuscular (deep to the fascia), and without metastases. Hence, it is a stage III tumor.
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