The Histopathologic Grading System of the French Federation of Cancer Centers (FNCLCC) for Adult Soft Tissue Sarcoma

 

The tumor is intended for sarcomas arising in the soft tissues of adults. It may be applied to recurrent sarcomas.

 

The grading system does not apply to:

(1) benign tumors

(2) tumors following treatment

(3) bone sarcomas (not soft tissue)

(4) based on core biopsies

(5) sarcomas arising in the uterus or GI tract

(6) pediatric sarcomas (not adult)

(7) dermatofibrosarcoma protuberans

(8) round cell liposarcomas

(9) epithelioid sarcoma

(10) alveolar soft part sarcoma

(11) clear cell sarcoma

 

Site selection: Most mitotically active area with 10 successive high powered (400x) microscopic fields. Exclude ulcerated, necrotic and hypocellular areas.

 

Parameters:

(1) tumor differentiation

(2) mitotic count in an area of 1.734 square mm (10 high powered fields with an area of 0.1734 square mm = diameter 0.47 mm = radius 0.235 mm)

(3) tumor necrosis

 

Parameter	Finding	Points
tumor differentiation	closely resemble normal adult soft tissue	1
	histologic typing is certain	2
	embryonal, undifferentiated or uncertain type	3
mitotic count	0 to 9	1
	10 to 19	2
	>= 20	3
tumor necrosis	none	0
	< 50%	1
	>= 50%	2

 

total score =

= SUM(points for all 3 areas)

 

Interpretation:

• minimum score: 2

• maximum score: 8

 

Score	Grade
2 or 3	Grade I
4 or 5	Grade II
6, 7 or 8	Grade III