Stomach cancer staging
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]
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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]