Stomach cancer staging

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

Stomach cancer Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differentiating Stomach Cancer from other Diseases
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic study of choice
Staging
History and Symptoms
Physical Examination
Laboratory Findings
Endoscopy and Biopsy
Chest X Ray
CT
MRI
Echocardiography or Ultrasound
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Cost-Effectiveness of Therapy
Future or Investigational Therapies
Case Studies
Case #1
Stomach cancer staging On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Stomach cancer staging All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Stomach cancer staging
CDC on Stomach cancer staging
Stomach cancer staging in the news
Blogs on Stomach cancer staging
Directions to Hospitals Treating Stomach cancer
Risk calculators and risk factors for Stomach cancer staging

Overview

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

Staging

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

Definitions of TNM

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

Adrenal cancer TNM staging

Stage	Description
TX	Primary tumor cannot be assessed
T0	No evidence of primary tumor
T1	Tumor ≤5 cm in greatest dimension limited to the adrenals
T2	Tumor >5 cm in greatest dimension, limited to the adrenals
T3	Tumor of any size with local invasion, but not invading adjacent organs
T4	Tumor of any size with invasion of adjacent organs

Regional Lymph Nodes (N)

Stage	Description
NX	Regional lymph node cannot be assessed
N0	No regional lymph node metastasis
N1	Regional lymph node metastasis

Distant Metastasis (M)

Stage	Description
M0	No distant metastasis
M1	Distant metastasis

Anatomic Stage/Prognostic Groups

Stage	T	N	M
I	T1	N0	M0
II	T2	N0	M0
III	T1	N1	M0
	T2	N1	M0
	T3	N0	M0
IV	T3	N1	M0
	T4	N0	M0
	T4	N1	M0
	Any T	Any N	M1