Calculators & Tools

Non-Rhabdomyosarcoma Soft-Tissue Sarcoma — Toronto Stage

Staged by resection status and metastatic disease.

1 What is the Non-Rhabdomyosarcoma Soft-Tissue Sarcoma — Toronto Stage?

The Non-Rhabdomyosarcoma Soft-Tissue Sarcoma — Toronto Stage is a oncology scoring tool used in paediatric practice. Staged by resection status and metastatic disease. It scores 1 criteria and interprets the total across 4 bands, so the number always arrives with the severity it implies rather than on its own. In PediAid each criterion is shown as a labelled option with the weight it carries, so the total can be checked rather than taken on trust.

2 When to use it

  • Grading severity at the bedside in oncology
  • Recording an objective severity band in the case notes
  • Deciding when a total crosses the threshold for escalation
  • Re-scoring to track whether a child is improving or deteriorating
  • Checking the exact criteria of a score used infrequently

3 Formula & method

The score sums 1 criteria: Extent and resection status. Totals are then banded: 1 stage or more - Stage I: completely resected localised NRSTS - surgery alone may suffice in low-grade small tumours; 2 stage or more - Stage II: localised but incompletely resected - consider re-excision, radiotherapy and chemotherapy by grade; 3 stage or more - Stage III: regional nodal disease - multimodal therapy required; 4 stage or more - Stage IV: metastatic NRSTS - poor prognosis; chemotherapy sensitivity varies widely by histological subtype.
  • Source: Gupta S, Aitken JF, Bartels U et al. Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines. Lancet Oncol 2016;17:e163-72.

4 Frequently asked questions

How many criteria does the Non-Rhabdomyosarcoma Soft-Tissue Sarcoma — Toronto Stage use?

1. They are Extent and resection status.

What do the bands of the Non-Rhabdomyosarcoma Soft-Tissue Sarcoma — Toronto Stage mean?

The total is interpreted as: 1 stage or more - Stage I: completely resected localised NRSTS - surgery alone may suffice in low-grade small tumours; 2 stage or more - Stage II: localised but incompletely resected - consider re-excision, radiotherapy and chemotherapy by grade; 3 stage or more - Stage III: regional nodal disease - multimodal therapy required; 4 stage or more - Stage IV: metastatic NRSTS - poor prognosis; chemotherapy sensitivity varies widely by histological subtype.

Does the score replace clinical judgement?

No. It is a structured way to record and communicate severity. A clinician concerned about a child should act on that concern regardless of the total.

Where does this score come from?

Source: Gupta S, Aitken JF, Bartels U et al. Paediatric cancer stage in population-based cancer registries: the Toronto consensus principles and guidelines. Lancet Oncol 2016;17:e163-72.

Does it work offline?

Yes. Score definitions are bundled with the PediAid app, so the score computes without a connection.

For qualified clinicians. This page and the PediAid app are a clinical aid only. Calculations and reference data must be verified against the patient's clinical context, the source guideline and your local protocols before any treatment decision is made.