Clear Cell Sarcoma
Grading / Staging / Report
According to the guidelines of the ADAP, clear cell sarcoma should not be graded because grade does not predict outcome
French Federation of Cancer Centers System grading scheme for adult sarcomas
- Tumor differentiation score = 3 for clear cell sarcoma
- Mitotic index
- 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:
- Location
- Type of resection or biopsy
- Histologic diagnosis
- Managerial category III (Local recurrence common, metastasis may occur)
- Extent of tumor cell necrosis
- State that this sarcoma is not considered gradable by the ADAP
- Stage
- Size
- Depth (dermis, subcutis, below fascia, body cavity)
- Margins
- Involved
- Not involved
- 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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