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Purpose <p>Optimal staging for sinonasal soft tissue sarcomas (SNSTS) remains unclear. The seventh edition of the American Joint Committee on Cancer staging system for soft tissue sarcoma (STS7) is size-based, while two eighth-edition alternatives, the head and neck soft tissue sarcoma system (STS8) and the sinonasal malignancy system (SNM8), incorporate anatomic invasion. None have been validated for SNSTS. This study compared their prognostic performance.</p> Methods <p>A retrospective cohort of 384 SNSTS cases was analyzed. STS7 was compared with STS8 and SNM8 across four performance dimensions using scoring measures: hazard consistency, hazard discrimination, prognostic accuracy, and T-category distribution. Time-dependent area under the curve and the Akaike information criterion were used to assess prognostic accuracy.</p> Results <p>STS8 showed better hazard consistency than STS7, while SNM8 lacked a monotonic survival gradient and demonstrated poor hazard discrimination. Prognostic accuracy was similar across current systems, but STS8 exhibited an uneven distribution, with 60.4% of cases classified as T4a. Overall performance was comparable between STS7 and STS8, while SNM8 was inferior.</p> Conclusion <p>STS7 and STS8 showed similar prognostic utility, whereas SNM8 performed worse. These findings support the development of a staging system tailored to SNSTS. Prospective validation is warranted.</p>

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Comparative validation of current staging systems in sinonasal soft tissue sarcomas: a population-based analysis

  • 期刊论文

  • 发表日期：

    2026年4月23日

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  • Jingtao Lin,
  • Weiping Wen,
  • Yihui Wen

摘要

Purpose

Optimal staging for sinonasal soft tissue sarcomas (SNSTS) remains unclear. The seventh edition of the American Joint Committee on Cancer staging system for soft tissue sarcoma (STS7) is size-based, while two eighth-edition alternatives, the head and neck soft tissue sarcoma system (STS8) and the sinonasal malignancy system (SNM8), incorporate anatomic invasion. None have been validated for SNSTS. This study compared their prognostic performance.

Methods

A retrospective cohort of 384 SNSTS cases was analyzed. STS7 was compared with STS8 and SNM8 across four performance dimensions using scoring measures: hazard consistency, hazard discrimination, prognostic accuracy, and T-category distribution. Time-dependent area under the curve and the Akaike information criterion were used to assess prognostic accuracy.

Results

STS8 showed better hazard consistency than STS7, while SNM8 lacked a monotonic survival gradient and demonstrated poor hazard discrimination. Prognostic accuracy was similar across current systems, but STS8 exhibited an uneven distribution, with 60.4% of cases classified as T4a. Overall performance was comparable between STS7 and STS8, while SNM8 was inferior.

Conclusion

STS7 and STS8 showed similar prognostic utility, whereas SNM8 performed worse. These findings support the development of a staging system tailored to SNSTS. Prospective validation is warranted.