Gastrointestinal stromal tumor staging

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2]

Gastrointestinal stromal tumor Microchapters
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Overview

According to the American Joint Committee on Cancer, there are 4 stages of stomach cancer based on the tumor spread.

Stage Information for GIST

Definitions of TNM (for GIST at All Sites) A formal staging system for gastrointestinal stromal tumors (GIST) appeared for the first time in the 7th edition of the American Joint Committee on Cancer (AJCC) Cancer Staging Manual. Because of the limited availability of mutation testing, mutation status is not included in the AJCC system. In addition, since nodal involvement is so rare, and nodal dissection is not indicated, the designation N0/pN0 should be used in the absence of information about the regional nodes. Note that treatment decisions may not be based strictly on the stage of disease.

Definitions of TNM (for GIST at All Sites)

Primary tumor

• TX:Primary tumor cannot be assessed

• T0:No evidence for primary tumor

• T1:Tumor ≤2 cm

• T2:Tumor >2 cm but not >5 cm

• T3:Tumor >5 cm but not >10 cm

• T4:Tumor >10 cm in greatest dimension

Regional Lymph Nodes (N)

• NX:Regional lymph nodes cannot be assessed

• N0:No regional lymph node metastasis

• N1:Regional lymph node metastasis

Distant Metastasis (M)

• M0:No distant metastasis

• M1:Distant metastasis

Anatomic Stage/Prognostic Groups

Gastric GIST

Group	T	N	M	Mitotic Rate
Stage IA	T1 or T2	N0	M0	Low
Stage IB	T3	N0	M0	Low
Stage II	T1	N0	M0	High
	T2	N0	M0	High
	T4	N0	M0	Low
Stage IIIA	T3	N0	M0	High
Stage IIIB	T4	N0	M0	High
Stage IV	Any T	N1	M0	Any rate
	Any T	Any N	M1	Any rate

Small Intestine GIST

Group	T	N	M	Mitotic rate
Stage I	T1 or T2	N0	M0	Low
Stage II	T3	N0	M0	Low
Stage IIIA	T1	N0	M0	High
	T4	N0	M0	Low
Stage IIIB	T2	N0	M0	High
	T3	N0	M0	High
	T4	N0	M0	High
Stage IV	Any T	N1	M0	Any rate
	Any T	Any N	M1	Any rate