National Comprehensive Cancer Network

About NCCN

NCCN Flash Update: NCCN Resources Updated for Soft Tissue Sarcoma

NCCN has published updates to the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), the NCCN Drugs & Biologics Compendium (NCCN Compendium®), the NCCN Imaging Appropriate Use Criteria (NCCN Imaging AUC™), and the NCCN Radiation Therapy Compendium™ for Soft Tissue Sarcoma. These NCCN Guidelines® are currently available as Version 1.2018.

  • Extremity/Superficial Trunk, Head/Neck
    • Stage II, III Resectable with acceptable functional outcomes (EXTSARC-3)
      • In footnote n, discussion of the data for RT has been expanded.
    • Metastatic disease (EXTSARC-6)
      • Surgery added to isolated limb perfusion/infusion for isolated regional or nodal disease
      • Footnote “aa” was added: “Perfusion/infusion should only be done at institutions with experience in regional limb therapy.”
  • Gastrointestinal Stromal Tumors (GIST)
    • Predictors of GIST Biologic Behavior, Non-gastric GISTs (GIST-A 3 of 3)
      • Tumor size, ≤2 cm, Mitotic Rate, ˃5 mitoses/50 HPFs, Metastasis rate: 50%-54%
      • Tumor size, ˃2 cm ≤5 cm, Mitotic Rate, ≤5 mitoses/50 HPFs, Metastasis rate: 1.9%-8.5%
      • Tumor size, ˃10 cm, Mitotic Rate, ˃5 mitoses/50 HPFs, Metastasis rate: 71%-90%
    • Principles of Pathologic Assessment for GIST (GIST-B)
      • Information regarding mutational testing for, and treatment response to, imatinib has been revised in the last bullet.
  • Principles of Imaging (SARC-A 1 of 3)
    • Chest imaging without contrast preferred unless contrast is needed for mediastinal imaging.
  • Principles of Ancillary Techniques Useful in the Diagnosis of Sarcomas (SARC-C 3 of 3)
    • The following genes were added for malignant peripheral nerve sheath tumor: NF1, CDKN2A and EED or SUZ12
  • Radiation Therapy Guidelines for Retroperitoneal/Intra-Abdominal Sarcoma (SARC-E 3 of 3)
    • Footnote “13” modified with new references added: “Postoperative RT following surgery is discouraged for retroperitoneal/intra-abdominal sarcoma. If RT is not given prior to surgical resection, consider follow-up with possible preoperative EBRT at time of localized recurrence. In highly select cases where a postoperative EBRT boost is considered, intraoperative placement of clips at areas of high risk for recurrence or anticipated R1/R2 resection is encouraged. When external beam RT is used in these rare situations, sophisticated treatment planning with IMRT, IGRT, and/or protons can be used to improve the therapeutic ratio.”
  • Systemic Therapy Agents and Regimens with Activity in Soft Tissue Sarcoma Subtypes  (SARC-F)
    • GIST (SARC-F 1 of 6)
      • Everolimus + TKI is new to GIST under disease progression after imatinib, sunitinib, and regorafenib.
        • The following footnote “l” corresponds: TKIs to be considered for use in combination with everolimus include imatinib, sunitinib, or regorafenib.
    • STS Subtypes with Non-Specific Histologies (SARC-F 1 of 6)
      • Trabectedin footnote “i” modified: Category 1 recommendation for liposarcoma and leiomyosarcoma
      • Eribulin Footnote “h” is new to the page: Category 1 recommendation for liposarcoma.
    • Solitary fibrous tumor/hemangiopericytoma  (SARC-F 2 of 6)
      • Sorafenib is a new agent with the following corresponding reference: Valentin T, Fournier C, Penel N, et al. Sorafenib in patients with progressive malignant solitary fibrous tumors: a subgroup analysis from a phase II study of the French Sarcoma Group (GSF/GETO). Invest New Drugs 2013;31(6):1626-1627.
  • The Soft Tissue Sarcoma Staging Tables reflect the AJCC Eighth Edition Cancer Staging System.


For the complete updated versions of the NCCN Guidelines, NCCN Guidelines with NCCN Evidence Blocks™, the NCCN Compendium®, the NCCN Biomarkers Compendium®, the NCCN Chemotherapy Order Templates (NCCN Templates®), the NCCN Radiation Therapy Compendium™, and the NCCN Imaging AUC™, please visit

To view the NCCN Guidelines for Patients®, please visit

Free NCCN Guidelines apps for iPhone, iPad, and Android smartphones & tablets are now available! Visit

About NCCN Flash Updates™ 
NCCN Flash Updates™ is a subscription service from NCCN that provides timely notification of updated and new information appearing in the NCCN Guidelines, the NCCN Compendium, and other NCCN Content. 

Subscribe to NCCN Flash Updates™ 

National Comprehensive Cancer Network® (NCCN®)
275 Commerce Drive, Suite 300
Fort Washington, PA 19034
Telephone: +1 215.690.0300 Fax: +1 215.690.0280 

Access information on permissions and licensing of NCCN Content  

© 2017 National Comprehensive Cancer Network. All Rights Reserved.