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
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Overview

According to the AJCC, 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