Stomach cancer staging: Difference between revisions

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{{CMG}}
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{{Stomach cancer}}
{{Stomach cancer}}


==Overview==
==Overview==
If cancer cells are found in the tissue sample, the next step is to [[cancer staging|stage]], or find out the extent of the disease. Various tests determine whether the cancer has spread and, if so, what parts of the body are affected. Because stomach cancer can spread to the liver, the pancreas, and other organs near the stomach as well as to the lungs, the doctor may order a [[CT scan]], an ultrasound exam, or other tests to check these areas.  Blood tests for [[tumor marker]]s, such as [[carcinoembryonic antigen]] (CEA) and carbohydrate antigen (CA) may be ordered, as their levels correlate to extent of metastasis, especially to the liver, and the cure rate.


Staging may not be complete until after surgery. The surgeon removes nearby lymph nodes and possibly samples of tissue from other areas in the abdomen for examination by a pathologist.
==Staging==
 
Definitions of TNM
 
The American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer
====Primary tumor====
 
*TX: Primary tumor cannot be assessed.
 
*T0: No evidence of primary tumor.
 
*Tis: Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria.
 
*T1: Tumor invades lamina propria, muscularis mucosae, or submucosa.
 
*T1a: Tumor invades lamina propria or muscularis mucosae.
 
*T1b: Tumor invades submucosa.
 
*T2: Tumor invades muscularis propria
 
*T3: Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures
 
*T4: Tumor invades serosa (visceral peritoneum) or adjacent structures
 
*T4a: Tumor invades serosa (visceral peritoneum)
 
*T4b: Tumor invades adjacent structures.
 
====Regional Lymph Nodes====
 
*NX: Regional lymph node(s) cannot be assessed
 
*N0: No regional lymph node metastasis
 
*N1: Metastases in 1–2 regional lymph nodes.
 
*N2: Metastases in 3–6 regional lymph nodes.
 
*N3: Metastases in ≥7 regional lymph nodes.
 
*N3a: Metastases in 7–15 regional lymph nodes.
 
*N3b: Metastases in ≥16 regional lymph nodes.
 
====Distant Metastasis====
 
*M0: No distant metastasis.
 
*M1: Distant metastasis.
 
===AJCC Stage Groupings===
 
====Stage 0=====
*Tis N0 M0
 
====Stage IA====
*T1 N0 M0
 
====Stage IB====
*T2 N0 M0
 
 
*T1 N1 M0
 
====Stage IIA====
*T3 N0 M0
 
*T2 N1 M0
 
*T1 N2 M0
 
====Stage IIB====
*T4a N0 M0
 
*T3 N1 M0
 
*T2 N2 M0
 
*T1 N3 M0
 
====Stage IIIA====
*T4a N1 M0
 
*T3 N2 M0
 
*T2 N3 M0
 
====Stage IIIB====
*T4b N0 M0
 
*T4b N1 M0
 
*T4a N2 M0
 
*T3 N3 M0
 
====Stage IIIC====
*T4b N2 M0
 
*T4b N3 M0
 
*T4a N3 M0
 
====Stage IV====
*Any T Any N M1 <ref>http://www.cancer.gov/types/stomach/hp/stomach-treatment-pdq#section/_17</ref>


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}


[[Category:Needs content]]
[[Category:Disease]]
[[Category:Disease]]
[[Category:Oncology]]
[[Category:Oncology]]

Revision as of 19:32, 26 August 2015

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Parminder Dhingra, M.D. [2] Editor-In-Chief: C. Michael Gibson, M.S., M.D. [3]

Stomach cancer Microchapters

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Risk calculators and risk factors for Stomach cancer staging

Overview

Staging

Definitions of TNM

The American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer

Primary tumor

  • TX: Primary tumor cannot be assessed.
  • T0: No evidence of primary tumor.
  • Tis: Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria.
  • T1: Tumor invades lamina propria, muscularis mucosae, or submucosa.
  • T1a: Tumor invades lamina propria or muscularis mucosae.
  • T1b: Tumor invades submucosa.
  • T2: Tumor invades muscularis propria
  • T3: Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures
  • T4: Tumor invades serosa (visceral peritoneum) or adjacent structures
  • T4a: Tumor invades serosa (visceral peritoneum)
  • T4b: Tumor invades adjacent structures.

Regional Lymph Nodes

  • NX: Regional lymph node(s) cannot be assessed
  • N0: No regional lymph node metastasis
  • N1: Metastases in 1–2 regional lymph nodes.
  • N2: Metastases in 3–6 regional lymph nodes.
  • N3: Metastases in ≥7 regional lymph nodes.
  • N3a: Metastases in 7–15 regional lymph nodes.
  • N3b: Metastases in ≥16 regional lymph nodes.

Distant Metastasis

  • M0: No distant metastasis.
  • M1: Distant metastasis.

AJCC Stage Groupings

Stage 0=

  • Tis N0 M0

Stage IA

  • T1 N0 M0

Stage IB

  • T2 N0 M0


  • T1 N1 M0

Stage IIA

  • T3 N0 M0
  • T2 N1 M0
  • T1 N2 M0

Stage IIB

  • T4a N0 M0
  • T3 N1 M0
  • T2 N2 M0
  • T1 N3 M0

Stage IIIA

  • T4a N1 M0
  • T3 N2 M0
  • T2 N3 M0

Stage IIIB

  • T4b N0 M0
  • T4b N1 M0
  • T4a N2 M0
  • T3 N3 M0

Stage IIIC

  • T4b N2 M0
  • T4b N3 M0
  • T4a N3 M0

Stage IV

  • Any T Any N M1 [1]

References

  1. ↑ http://www.cancer.gov/types/stomach/hp/stomach-treatment-pdq#section/_17

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