The 5-year survival rate for soft tissue sarcomas is reported at 66% by both the SEER database and the National Cancer Institute (NCI). This is a rate similar to that for bone and joint, uterine/ovarian, and non-Hodgkin lymphoma cancers. Average length of survival after diagnosis is 7 years, similar to that of breast, urinary, and nervous system cancers. White women have a slightly higher 5-year survival rate than do men, and live an average of 1 year longer after diagnosis. However, the reverse is true for Black women, who die an average of 2 years sooner than Black men diagnosed with soft tissue sarcoma. (Reference Table 8A.4.1 PDF CSV, Table 8A.4.2 PDF CSV, and Table 8A.4.3 PDF CSV)
For high-grade soft tissue sarcomas, the most important prognostic factor is the stage at which the tumor is identified. Staging criteria for soft tissue sarcomas are primarily determined by whether the tumor has metastasized or spread elsewhere in the body. Size is highly correlated with risk of metastasis and survival. In general, the prognosis for a soft tissue sarcoma is poorer if the sarcoma is large. As a general rule, high-grade soft tissue sarcomas over 10 cm in diameter have an approximate 50% mortality rate and those over 15 cm in diameter have an approximate 75% mortality rate.
The NCI statistics staging classification of sarcomas is Stage 1, confined to the primary site (localized: 54% of sarcomas are diagnosed at this stage); Stage 2, spread to regional lymph nodes or directly beyond the primary site (regional: 22%); or Stage 3, metastasized (distant: 15%). For the remaining cases, the staging information was unknown. The corresponding 5-year relative survival rates reported are 84% for localized sarcomas, 62% for regional stage sarcomas, 16% for sarcomas with distant spread, and 54% for unstaged sarcomas. The 10-year relative survival rate is only slightly worse for these stages, meaning that most people who survive 5 years are cured.1
Using the staging criteria of soft tissue sarcomas of the American Joint Committee on Cancer (AJCC) produces similar results for sarcomas found in the limbs (arms or legs): 90% 5-year survival rate for Stage 1 sarcomas; 81% for Stage 2; and 56% for Stage 3. Sarcomas identified as Stage 4 have a very low 5-year survival rate. Sarcomas located in other than a limb also have lower survival rates.1
Sarcomas are often staged by orthopedic oncologists with a staging system established by Dr. William Enneking, and adopted and modified by surgical societies primarily consisting of orthopedic oncologists. That may have accounted for the lack of AJCC staging data in many cases of bone and soft tissue sarcomas reported to the NCDB. Nearly 40% of cases for 2000–2011 reported in the NCDB data have an unknown stage. This is a much higher proportion than found among other common cancer types, making it difficult to compare the severity of soft tissue sarcomas to other cancers. However, none of the cases was identified as Stage 1, with the majority at Stage 2 through Stage 4. (Reference Table 8A.5.1 PDF CSV)
- 1. a. b. National Cancer Society (NCS): How Are Soft Tissue Sarcomas Staged? Available at: http://www.cancer.org/cancer/sarcoma-adultsofttissuecancer/detailedguide/sarcoma-adult-soft-tissue-cancer-staging. Accessed February 16, 2015.