Stomach cancer Diagnostic study of choice
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Omer Kamal, M.D.[2], Parminder Dhingra, M.D. [3], Mohammed Abdelwahed M.D[4]
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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.
Staging
There are two major classification systems currently in use for gastric cancer; the Japanese classification. The other and more widely used staging system is the American Joint Committee on Cancer has designated staging by TNM classification to define gastric cancer:[1]
Definitions of TNM
| Stage | Description |
|---|---|
| TX | Primary tumor cannot be assessed |
| Tis | Carcinoma in situ: intraepithelial tumor without invasion of the lamina propria |
| T0 | No evidence of primary tumor |
| T1 | Tumor invades lamina propria, muscularis mucosae, or submucosa
T1a: Tumor invades lamina propria or muscularis mucosae |
| T2 | Tumor invades muscularis propria |
| T3 | Tumor penetrates subserosal connective tissue without invasion of visceral peritoneum or adjacent structures |
| T4 | T4: Tumor invades serosa (visceral peritoneum) or adjacent structures
T4a: Tumor invades serosa (visceral peritoneum) T4b: Tumor invades adjacent structures |
| Stage | Description |
|---|---|
| NX | Regional lymph node cannot be assessed |
| N0 | No regional lymph node metastasis |
| N1 | Metastasis in 1-2 regional lymph nodes |
| N2 | Metastasis in 3-6 regional lymph nodes |
| N3 | Metastasis in seven or more regional lymph nodes
N3a: Metastasis in 7-15 regional lymph nodes N3b: Metastasis in 16 or more regional lymph nodes |
| Stage | Description |
|---|---|
| M0 | No distant metastasis |
| M1 | Distant metastasis |
| Stage | T | N | M | |
|---|---|---|---|---|
Stage 0 |
Tis | N0 | M0 | |
| I | Stage IA | T1 | N0 | M0 |
| Stage IB | T2 | N0 | M0 | |
| T1 | N1 | M0 | ||
| II | Stage IIA | T3 | N0 | M0 |
| T2 | N1 | M0 | ||
| T1 | N2 | M0 | ||
| Stage IIB | T4a | N0 | M0 | |
| T3 | N1 | M0 | ||
| T2 | N2 | M0 | ||
| III | Stage IIIA | T1 | N1 | 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 | |
References
- ↑ In H, Solsky I, Palis B, Langdon-Embry M, Ajani J, Sano T (2017). "Validation of the 8th Edition of the AJCC TNM Staging System for Gastric Cancer using the National Cancer Database". Ann Surg Oncol. 24 (12): 3683–3691. doi:10.1245/s10434-017-6078-x. PMID 28895113.