Metastasis and death may occur late (>10 years), even if clearly excised with no local recurrence
5 year survival 60% but 20 year survival 15%
Pediatric cases may have better survival
Grading / Staging / Report
According to the guidelines of the ADASP, alveolar soft part sarcoma is not considered gradable although it often metastasizes
French Federation of Cancer Centers System grading scheme for adult sarcomas
Tumor differentiation score = 3 for alveolar soft part sarcoma
Score 1 0-9 mitoses per 10 hpf (0.1744 sq mm)
Score 2 10-19 mitoses per 10 hpf
Score 3 >19 mitoses per 10 hpf
Tumor cell necrosis
Score 0 No necrosis on any slide (one slide per 2 cm tumor diameter)
Score 1 <50% of tumor is necrotic on slides examined
Score 2 >50% of tumor is necrotic on slides examined
Final Grade (add the three scores above)
Grade 1 Sum of scores = 2 or 3
Grade 2 Sum of scores = 4 or 5
Grade 3 Sum of scores = 6 or more
Use TNM Staging
The surgical pathology report should contain or address the following:
Type of resection or biopsy
Managerial category IV (Systemic disease assumed to be present at the outset)
Extent of tumor cell necrosis
Depth (dermis, subcutis, below fascia, body cavity)
If under 2 cm give all such distances and sites
If over 2 cm give minimum distance and site
Results of supplementary studies if performed
Relationship to other specimens from the same patient
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